Gamma Knife Radiosurgery for Advanced and Recurrent Juvenile Nasopharyngeal Angiofibroma: A Case Series

• Published in: Brain tumor research and treatment Vol. 13; no. 3; pp. 106 - 111
• Main Authors: Lee, Jong Seok, Lee, Jung-Il
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Brain Tumor Society; The Korean Society for Neuro-Oncology; The Korean Society for Pediatric Neuro-Oncology 01.07.2025; 대한뇌종양학회
• Subjects: Case Report; 신경외과학; Neoplasm; Pediatrics; Recurrence; Angiofibroma; Radiosurgery
• ISSN: 2288-2405; 2288-2413; 2288-2413
• DOI: 10.14791/btrt.2025.0014

Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign, but locally aggressive tumor that typically affects adolescent males. While surgical resection is the standard treatment, achieving total resection is often challenging in advanced-stage tumors with intracranial extension, resulting in high recurrence rates. Gamma knife radiosurgery (GKRS) has been suggested as a potential adjuvant or salvage therapy, but evidence remains limited. In this study, we report three pediatric cases of advanced-stage JNA treated with GKRS following incomplete surgical resection. Two patients demonstrated durable local tumor control with a significant reduction in tumor size until 2 and 12 years after GKRS. The other patient with partial coverage of tumor by prescription isodose 12 Gy showed a reduction of tumor volume at 6 months but subsequent progression at 1 year. No GKRS-related complications were observed during the follow-up period. Our findings suggest that GKRS appears to be a potentially safe and effective treatment modality for residual or recurrent JNAs. Fractionated or staged GKRS combined with surgery may be a preferable strategy for large tumors in which extensive surgery alone, conventional radiotherapy, or single-fraction radiosurgery may be associated with increased morbidity in pediatric populations.