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Table of Contents    
NEUROIMAGES
Year : 2019  |  Volume : 67  |  Issue : 3  |  Page : 926

Tumefactive cyst after stereotactic radiosurgery for cerebral arteriovenous malformation


1 3d Diagnostico/Hospital Rede Casa Rua do Bispo, 72. Rio Comprido – Rio de Janeiro. Rio de Janeiro, CEP 20261-064, Brazil
2 3d Diagnostico/Hospital Rede Casa Rua do Bispo, 72. Rio Comprido – Rio de Janeiro. Rio de Janeiro, CEP 20261-064; Instituto Estadual do Cérebro Paulo Niemeyer Rua do Rezende, 156, Centro – Rio de Janeiro, Rio de Janeiro, CEP 20231-092, Brazil
3 Instituto Estadual do Cérebro Paulo Niemeyer Rua do Rezende, 156, Centro – Rio de Janeiro, Rio de Janeiro, CEP 20231-092, Brazil
4 Hospital Universitário Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255 – Ilha do Fundão, Rio de Janeiro, Rio de Janeiro, CEP 21941-590, Brazil

Date of Web Publication23-Jul-2019

Correspondence Address:
Dr. Bruno Niemeyer
Instituto Estadual do Cérebro Paulo Niemeyer Rua do Rezende, 156. Centro – Rio de Janeiro, Rio de Janeiro, CEP 20231-092
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.263229

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How to cite this article:
Pereira RG, Niemeyer B, Ferreira C, Coutinho Pereira TR, Gasparetto E, Marchiori E. Tumefactive cyst after stereotactic radiosurgery for cerebral arteriovenous malformation. Neurol India 2019;67:926

How to cite this URL:
Pereira RG, Niemeyer B, Ferreira C, Coutinho Pereira TR, Gasparetto E, Marchiori E. Tumefactive cyst after stereotactic radiosurgery for cerebral arteriovenous malformation. Neurol India [serial online] 2019 [cited 2019 Dec 7];67:926. Available from: http://www.neurologyindia.com/text.asp?2019/67/3/926/263229




A 40-year old woman who had undergone stereotactic radiosurgery (SR) for treatment of an arteriovenous malformation 3 years prior, presented with progressive headache associated with seizures. These symptoms persisted for 2 months. Brain magnetic resonance imaging (MRI) revealed a tumefactive cyst with adjacent edema impinging upon the thalamus and left nucleus-capsular region [Figure 1].
Figure 1: Brain MRI findings. (a) MRI demonstration of a cyst (arrow) associated with edema of the adjacent cerebral parenchyma (arrowhead) in FLAIR MR sequence. (b) A peripheral hypointensity (arrow) is seen in magnetic susceptibility sequence. (c) Fat-suppressed T1 sequence with contrast medium (arrows) is possibly corresponding to hemoglobin degradation products. (d) Maximum intensity projection of three-dimensional time-of-flight MRI showing no residual arteriovenous malformation

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A tumefactive cyst is a late and rare complication of SR, affecting about 1.5% of patients. Commonly, the cyst manifests 2–7 years after the administration of SR. In most cases, it is asymptomatic and arises in locations where patients have been irradiated. When patients are symptomatic or experiencing a mass effect, the cyst may be treated by surgical resection.[1],[2]

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  References Top

1.
Al Hinai Q, Tampieri D, Souhami L, Sadikot A, Sinclair D, Leblanc R. Cyst formation following radiosurgery for AVMs: Report of 3 cases. Can J Neurol Sci 2011.  Back to cited text no. 1
    
2.
Wolak ML, Murphy EC, Powell SZ. Tumefactive cyst with a vascular blush as a late complication after combined embolization and stereotactic radiosurgery treatments for a cerebral arteriovenous malformation. Acta Neurochir (Wien) 2007;149:705-12.  Back to cited text no. 2
    


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