Selective conformal radiotherapy for arteriovenous malformation involving the spinal cord

Radiotherapy has seldom been used in the treatment of arteriovenous malformations (AVM) involving the spinal cord because of the cord's limited radiation tolerance. A 57-year-old woman with progressive myelopathy due to AVM was treated with a selective conformal radiation therapy (55.6 Gy/20 days) on the nidus region preserving the spinal cord, drainer veins and involved bones. The drainers and symptoms were minimized at the end of treatment and disappeared over 2 years. This case illustrates the usefulness of selective conformal radiation therapy.