재발된 상악암에 의한 압박 시신경병증을 정위적 방사선수술로 치료한 1예
Treatment of Compressive Optic Neuropathy by Recurred Maxillary Cancer Using Stereotactic Radiosurgery: A Case Report
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서론: 재발된 상악암에 의하여 발생한 압박 시신경병증을 정위적방사선수술로 치료한 증례를 보고하고자 한다. 증례요약: 상악암의 병력이 있는 51세 여자가 우안의 시력감소, 시야이상과 색각이상을 주소로 내원하였다. 전산화단층촬영상 사골동,안와, 시신경굴과 두개골저에 이르는 종괴가 발견되어, 압박 시신경병증으로 진단하고 정위적 방사선수술을 시행하였으며 총 39 Gy를3일에 나누어 분할조사하였다. 10일 뒤에 시력, 색각과 시야는 호전되었으며, 이는 2개월 추적관찰 시까지 유지되었다. 결론: 정위적 방사선수술은 재발한 악성종양에 의한 압박 시신경병증에 대한 치료 방법으로 고려될 수 있다.
Abstract
Purpose: To report a case of a female patient treated with stereotactic radiosurgery for compressive optic neuropathy by recurred maxillary cancer. Case summary: A 51-year-old woman with a history of maxillary cancer presented with decreased visual acuity and visual field and color vision defects in the right eye. The CT scan revealed a wide spread mass along the ethmoid sinus, orbit, optic canal, and skull base. Under the impression of compressive optic neuropathy, stereotactic radiosurgery was performed. A cumulative dose of 39 Gy in 3 daily fractions of 13 Gy was administered to the mass. After 10 days, visual acuity, color vision, and visual field improved and were maintained after a 2 month follow-up. Conclusions: Stereotactic radiosurgery could be another treatment option for patients with compressive optic neuropathy caused by a malignant tumor.
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