Intracranial sarcoma in a patient with neurofibromatosis type 2 treated with gamma knife radiosurgery for vestibular schwannoma

Objective: To discuss the possible relationship between stereotactic radiat ion therapy and the development of a meningosarcoma. Study Design: Retrospective case review. Patient: A 19-year-old woman with bilateral vestibular schwannomas (neurofi bromatosis type). One large tumor was removed totally by the translabyrinth ine approach; the other smaller tumor was treated with stereotactic radiati on (SRT). Six years after SRT, a malignant tumor (meningosarcoma) developed at the exact site of radiation. The patient subsequently died of this tumo r. Outcome Measure: On the basis of literature surveys, the possibility and ri sk; of postirradiation neoplasia after SRT is discussed. Furthermore, the p ossible causal association between SRT and the development of the meningosa rcoma in this case is evaluated. Conclusion: On the basis of statistical considerations, the development of the reported mesenchymal sarcoma was most likely caused by the Stereotactic radiation therapy.