Endolymphatic Sac Tumor. Post-Radiosurgery Evaluation Using Time-Resolved Imaging of Contrast Kinetics MR Angiography

Area of Science:

• Neuro-oncology
• Radiosurgery
• Rare tumors

Background:

• Endolymphatic sac tumors (ELST) are rare, aggressive, hypervascular tumors originating in the posterior petrous bone.
• ELST can occur independently or be associated with Von Hippel-Lindau (VHL) syndrome.
• Current primary treatment involves surgical excision, with radiotherapy's role under investigation.

Purpose of the Study:

• To report a case of ELST associated with VHL syndrome.
• To evaluate the efficacy of stereotactic radiosurgery as a sole treatment modality for ELST.
• To demonstrate the utility of time-resolved imaging of contrast kinetics (TRICKS) MRI in monitoring tumor response.

Main Methods:

• A case report of a 35-year-old female patient with ELST and VHL syndrome.
• Management solely with stereotactic radiosurgery.
• Tumor response monitored using time-resolved imaging of contrast kinetics (TRICKS) MRI.

Main Results:

• Successful management of the ELST using stereotactic radiosurgery as the only intervention.
• TRICKS MRI effectively monitored the tumor's response to radiosurgery.
• This approach offers a potential alternative to surgical intervention for select ELST cases.

Conclusions:

• Stereotactic radiosurgery can be an effective sole treatment for endolymphatic sac tumors associated with VHL syndrome.
• Time-resolved imaging of contrast kinetics MRI is a valuable tool for assessing treatment response in these tumors.
• This case highlights a less invasive management strategy for rare ELST.