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Case Reports in Neurological Medicine
Volume 2015, Article ID 872915, 5 pages
http://dx.doi.org/10.1155/2015/872915
Case Report

Prolonged Survival following Repetitive Stereotactic Radiosurgery in a Patient with Intracranial Metastatic Renal Cell Carcinoma

1Gamma Knife of Spokane, 910 W 5th Avenue, Suite 102, Spokane, WA 99204, USA
2Cancer Care Northwest, 910 W 5th Avenue, Suite 102, Spokane, WA 99204, USA
3University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA
4Inland Neurosurgery & Spine Associates, 105 W 8th Avenue, Suite 200, Spokane, WA 99204, USA
5Rockwood Clinic, 801 W 5th Avenue, Suite 525, Spokane, WA 99204, USA

Received 28 August 2015; Accepted 13 October 2015

Academic Editor: Mehmet Turgut

Copyright © 2015 Ethan A. Ferrel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with metastatic renal cell carcinoma (RCC) to the brain have a very poor prognosis of three months if left untreated. SRS is an effective treatment modality in numerous patients. This case exemplifies the utility of stereotactic radiosurgery (SRS) in prolonging survival and maintaining quality of life in a patient with RCC. This 64-year-old female patient initially presented to her primary care physician 22 months after a left nephrectomy for RCC with complaints of mild, intermittent headaches and difficulty with balance. An MRI revealed five cerebellar lesions suspicious for intracranial metastasis. The patient’s first GKRS treatment targeted four lesions with 22 Gy at the 50% isodose line. She underwent a total of seven GKRS treatments over the next 60 months for recurrent metastases to the brain. 72 months and 12 months have now passed since her brain metastases were first discovered and since her last GKRS treatment, respectively, and this woman is alive with considerable quality of life and no evidence of metastatic reoccurrence. This case shows that repeated GKRS treatments, with minimal surgical intervention, can effectively treat multiple intracranial lesions in select patients, prolonging survival and avoiding iatrogenic neurocognitive decline while maintaining a high quality of life.