ArticleOtology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology2021
Dramatic Growth of a Vestibular Schwannoma After 16 Years of Postradiosurgery Stability in Association With Exposure to Tyrosine Kinase Inhibitors.
Article in Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 3 citations in OpenAlex.
- Trochlear nerve schwannoma with concomitant osimertinib-responsive stage IV lung adenocarcinoma: illustrative case.Journal of neurosurgery. Case lessons · 2024Article
- Development and Validation of a Deep Learning Predictive Model Combining Clinical and Radiomic Features for Short-Term Postoperative Facial Nerve Function in Acoustic Neuroma Patients.Current medical science · 2023Article
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5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundVestibular schwannoma (VS) is a benign nerve-sheath tumor that sporadically displays aggressive behavior - often attributable to intrinsic tumor biology and an unfavorable immune microenvironment. However, the potential for idiosyncratic responses on VS growth to novel biologics is largely unknown.
methodsCase report.
resultsA 57-year-old man underwent stereotactic radiosurgery (SRS) for a small intracanalicular presumed VS, which presented with left-sided hearing loss and episodic vertigo. Treatment response was excellent, with >50% reduction in tumor volume and confirmed stability at 14 years post-SRS radiographic follow-up. The patient subsequently developed an unrelated metastatic gastrointestinal tumor, and was started on tyrosine kinase inhibitors. Within 12-months of regorafenib treatment, and 16-years since SRS, the patient developed ipsilateral House-Brackmann Grade IV facial weakness. Dramatic VS expansion from 14 to 25 mm in maximum diameter, with new brain stem compression, was seen on MRI. Due to poor prognosis of his gastrointestinal malignancy, he declined surgical resection, and elected for palliative salvage SRS.
conclusionWe report the case of VS with radiographically proven stability for >14 years that underwent dramatic tumor progression after treatment with tyrosine kinase inhibitors. The dynamics between systemic immunomodulation and VS disease phenotype remain incompletely understood, and there may be potential for unintended iatrogenic VS progression.
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