Stereotactic radiosurgery for brain metastases secondary to adrenal ganglioneuroblastoma: illustrative case.

backgroundNeuroblastic tumors, including malignant neuroblastoma, ganglioneuroblastoma (GNB), and benign ganglioneuroma, are embryonal tumors derived from neural crest cells. GNB often metastasizes to the bone marrow and bone, with lung and brain metastases (BMs) remaining extremely rare. To date, only 2 prior reports of GNB BM exist, with both cases documenting resection alone. Therefore, the management of GNB BM has yet to be fully investigated. OBSERVATIONS: The present study describes an 11-year-old male with BM secondary to primary adrenal GNB and the use of stereotactic radiosurgery (SRS) to treat these lesions. These are both without precedent in the current literature. The patient initially underwent 2 surgical interventions, with the second surgery performed due to local recurrence. He subsequently received 3 rounds of SRS treatment with favorable short-term outcomes, including complete resolution of the relatively large left temporal lesion. LESSONS: A primary surgical approach enabled pathological analysis and contributed to initial prolonged survival. However, a second surgery was required due to local progression. Subsequent SRS showed favorable outcomes after the 3 interventions without impairing the clinical course with systemic therapy. Comparative studies are needed to optimize the treatment strategy between surgical management and SRS as stand-alone or adjuvant therapy. https://thejns.org/doi/10.3171/CASE24820.