Multiple central nervous system tumors and combined treatment modalities - an illustrative case

ABSTRACT

Multiple space occupying lesions in the craniospinal axis pose special type of challenges in their management. Surgeries for decompression or total excision of the symptomatic tumors at various sites and at different times are needed. Radiosurgery and administration of chemotherapeutic agents are other modalities for the treatment of such lesions caused by benign or malignant conditions and acute or chronic infections. We report a case of a young woman with central neurofibromatosis harbouring bilateral acoustic neurinomas multiple meningiomas and other cranial and spinal neurofibromas. she underwent radiosurgery for the right vestibular schwannoma [VS] and surgery for the left sphenoidal wing meningioma and a large right C5 nerve root neurofibroma. There was no evidence of tumor necrosis or shrinkage 4 years after the radiosurgery. Brain stem compression increased over 4 years period. she is likely to need futher intervention for symptomatic lesions