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. 2020 Sep 28;12(9):e10692.
doi: 10.7759/cureus.10692.

CyberKnife Radiotherapy for Skull Base Petroclival Metastases Including Dorello's Canal: Report of 10 Cases

Shinichiro Miyazaki  1 , Yuko Harada  1 , Yusuke Sasaki  2 , Takanori Fukushima  3
Affiliations

CyberKnife Radiotherapy for Skull Base Petroclival Metastases Including Dorello's Canal: Report of 10 Cases

Shinichiro Miyazaki et al. Cureus. .

Abstract

Skull base petroclival metastases cause diplopia due to abducens nerve palsy. Diplopia is visually disabling, and skull base metastasis is extremely difficult to treat even with microscopic surgery. However, stereotactic radiotherapy with CyberKnife (Accuray Incorporated, Sunnyvale, California) has been very successful in 10 cases. As the abducens nerve runs through Dorello's canal in the skull base, the radiation dose and fraction were adjusted to avoid damage to the nerve. Since these metastases are not located inside the brain but in the skull base, contrast magnetic resonance imaging (MRI) combined with fluorodeoxyglucose-positron emission tomography (FDG-PET) was essential to detect the cancers.

Keywords: abducens nerve palsy; cyberknife; dorello's canal; skull base metastasis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. FDG-PET of Case 1
FDG-PET before CyberKnife (top) and after CyberKnife (bottom). The tumor (red arrow) disappeared after treatment. FDG-PET: fluorodeoxyglucose-positron emission tomography
Figure 2
Figure 2. CyberKnife treatment plan for Case 1
Contour maps were drawn around the tumor (red arrow).
Figure 3
Figure 3. Contrast-enhanced MRI of Case 1
Contrast-enhanced MRI before CyberKnife (top) and after CyberKnife (bottom). The tumor in the petroclivus (red arrow) disappeared after treatment. MRI: magnetic resonance imaging
Figure 4
Figure 4. CyberKnife treatment plan of Case 7
Contour maps were drawn around the tumor (red arrow).
Figure 5
Figure 5. Contrast-enhanced MRI of Case 7
Contrast-enhanced MRI before CyberKnife (top) and after CyberKnife (bottom). The tumor located in Dorello's canal (red arrow) disappeared after treatment. MRI: magnetic resonance imaging
See this image and copyright information in PMC

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