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Delayed-Onset Cyst Formation After Laser Interstitial Thermal Therapy: Unreported Long-Term Complication
Arthur Carminucci1, Matthew Parr1, Mireille Bitar2
1Department of Neurological Surgery, Rutgers University, New Brunswick, New Jersey, USA.
Background:
The majority of complications following (LITT) therapy occur in the early postoperative period, with few long-term complications being reported.
Case Description:
Here we present 2 cases of delayed-onset cyst formation occurring more than 1 year following ablation, a previously unreported complication. In the first case, a 59-year-old female who previously underwent LITT for a radiation-induced cavernoma developed a 2-cm cystic lesion 18 months after ablation, resulting in recurrent seizures. In the second case, a 53-year-old female with a recurrent left frontal cerebral metastasis developed a large cystic lesion 30 months post ablation. Both patients required craniotomies and resection of their cystic lesions. In both cases pathology demonstrated reactive gliosis and blood vessel sclerosis.
Conclusions:
We hypothesize chronic gliosis following LITT therapy results in blood vessel sclerosis leading to blood-brain barrier-breakdown and delayed cyst formation. These findings support the need for long-term surveillance of patients treated with LITT.
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