{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:55:33Z","timestamp":1770184533119,"version":"3.49.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"15","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,4,14]]},"abstract":"\n BACKGROUND<\/jats:title>\n Spheno-orbital meningiomas (SOMs) pose significant challenges due to their proximity to critical structures, such as the optic nerve. This report underscores the pivotal role of meticulous planning in achieving favorable outcomes with Gamma Knife radiosurgery (GKRS).<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 54-year-old woman with a left SOM encasing the optic nerve underwent GKRS after being deemed unsuitable for surgery. The radiosurgical plan was meticulously tailored to balance effective tumor control with optic nerve sparing. A prescribed dose of 10 Gy at the 50% isodose line ensured a maximum optic nerve dose of 9.6 Gy, remaining within safe limits. Metrics such as high target coverage (0.96) and conformity (Paddick index: 0.83) highlighted the precision of the approach. A 12-year follow-up demonstrated stable tumor volume and preserved visual function without adverse effects, confirming the long-term efficacy and safety of this strategy. This case underscores the critical importance of comprehensive dose planning, particularly for perioptic lesions, where the therapeutic margin is narrow.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n GKRS offers a minimally invasive alternative for SOMs ineligible for surgery, emphasizing the need for individualized treatment strategies. This case highlights how tailored radiosurgical planning can optimize outcomes, preserve function, and improve quality of life for patients with complex skull base tumors.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE2530<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case2530","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T20:16:21Z","timestamp":1744661781000},"source":"Crossref","is-referenced-by-count":0,"title":["Optimizing outcome in radiosurgery for spheno-orbital meningioma: the critical role of planning quality. Illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Ali Haluk","family":"D\u00fczkalir","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Ko\u00e7 University Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yavuz","family":"Samanci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ko\u00e7 University Hospital, Istanbul, Turkey"},{"name":"Department of Neurosurgery, Ko\u00e7 University School of Medicine, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7126-6373","authenticated-orcid":true,"given":"Orbay","family":"Askeroglu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Center, Ko\u00e7 University Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-3355","authenticated-orcid":true,"given":"Selcuk","family":"Peker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Center, Ko\u00e7 University Hospital, Istanbul, Turkey"},{"name":"Department of Neurosurgery, Ko\u00e7 University School of Medicine, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"suppl","key":"bib1","series-title":"J Neurosurg","first-page":"102","article-title":"Multisession Gamma Knife surgery for benign orbital tumors","volume":"117","author":"Jo","year":"2012","unstructured":"Jo KIIm YSKong DSMultisession Gamma Knife surgery for benign orbital tumors. J Neurosurg. 2012;117(suppl):102-107."},{"issue":"6","key":"bib2","series-title":"J Neurosurg","first-page":"951","article-title":"Surgical management of meningiomas involving the optic nerve sheath","volume":"101","author":"Schick","year":"2004","unstructured":"Schick UDott UHassler W.Surgical management of meningiomas involving the optic nerve sheath. J Neurosurg. 2004;101(6):951-959."},{"issue":"5","key":"bib3","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Meningiomas involving the optic canal: pattern of involvement and implications for surgical technique","volume":"30","author":"Taha","year":"2011","unstructured":"Taha ANMErkmen KDunn IFPravdenkova SAl-Mefty O.Meningiomas involving the optic canal: pattern of involvement and implications for surgical technique. Neurosurg Focus. 2011;30(5):E12."},{"issue":"4","key":"bib4","series-title":"J Neurosurg","first-page":"1044","article-title":"Sphenoorbital meningioma: a unique skull base tumor. Surgical technique and results","volume":"133","author":"Kiyofuji","year":"2020","unstructured":"Kiyofuji SCasabella AMGraffeo CSPerry AGarrity JALink MJ.Sphenoorbital meningioma: a unique skull base tumor. Surgical technique and results. J Neurosurg. 2020;133(4):1044-1051."},{"key":"bib5","series-title":"J Clin Neurosci","first-page":"409","article-title":"Clinical outcomes of fractionated stereotactic radiosurgery in treating perioptic meningiomas and schwannomas: a single-institutional experience","volume":"81","author":"Chen","year":"2020","unstructured":"Chen HYChuang CCChen HCClinical outcomes of fractionated stereotactic radiosurgery in treating perioptic meningiomas and schwannomas: a single-institutional experience. J Clin Neurosci. 2020;81:409-415."},{"issue":"2","key":"bib6","series-title":"Neurosurgery","first-page":"285","article-title":"Long-term tumor control and functional outcome in patients with cavernous sinus meningiomas treated by radiotherapy with or without previous surgery: is there an alternative to aggressive tumor removal?","volume":"48","author":"Dufour","year":"2001","unstructured":"Dufour HMuracciole XM\u00e9tellus PR\u00e9gis JChinot OGrisoli F.Long-term tumor control and functional outcome in patients with cavernous sinus meningiomas treated by radiotherapy with or without previous surgery: is there an alternative to aggressive tumor removal? Neurosurgery. 2001;48(2):285-296."},{"issue":"4","key":"bib7","series-title":"Neurosurgery","first-page":"828","article-title":"Stereotactic radiosurgery for perioptic meningiomas: an international, multicenter study","volume":"88","author":"Bunevicius","year":"2021","unstructured":"Bunevicius AAnand RKSuleiman MStereotactic radiosurgery for perioptic meningiomas: an international, multicenter study. Neurosurgery. 2021;88(4):828-837."},{"issue":"1","key":"bib8","series-title":"Int J Radiat Oncol Biol Phys","first-page":"87","article-title":"Single- and multi-fraction stereotactic radiosurgery dose tolerances of the optic pathways","volume":"110","author":"Milano","year":"2021","unstructured":"Milano MTGrimm JSoltys SGSingle- and multi-fraction stereotactic radiosurgery dose tolerances of the optic pathways. Int J Radiat Oncol Biol Phys. 2021;110(1):87-99."},{"issue":"5","key":"bib9","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1177","article-title":"A study on the radiation tolerance of the optic nerves and chiasm after stereotactic radiosurgery","volume":"55","author":"Stafford","year":"2003","unstructured":"Stafford SLPollock BELeavitt JAA study on the radiation tolerance of the optic nerves and chiasm after stereotactic radiosurgery. Int J Radiat Oncol Biol Phys. 2003;55(5):1177-1181."},{"issue":"suppl 2","key":"bib10","series-title":"Neuro-Oncol","first-page":"ii122","article-title":"P18.03. A hypofractionation with optimized stereotactic radiosurgery planning for skull base perioptic meningiomas","volume":"25","author":"Cho","year":"2023","unstructured":"Cho YYoon KLee DP18.03. A hypofractionation with optimized stereotactic radiosurgery planning for skull base perioptic meningiomas. Neuro-Oncol. 2023;25(suppl 2):ii122."},{"issue":"3","key":"bib11","series-title":"J Neurooncol","first-page":"679","article-title":"Clinical outcomes of perioptic tumors treated with hypofractionated stereotactic radiotherapy using CyberKnife\u00ae stereotactic radiosurgery","volume":"139","author":"Puataweepong","year":"2018","unstructured":"Puataweepong PDhanachai MHansasuta AClinical outcomes of perioptic tumors treated with hypofractionated stereotactic radiotherapy using CyberKnife\u00ae stereotactic radiosurgery. J Neurooncol. 2018;139(3):679-688."},{"issue":"3","key":"bib12","series-title":"J Neurosurg","first-page":"780","article-title":"Single-session stereotactic radiosurgery for large perioptic meningiomas","volume":"139","author":"El-Shehaby","year":"2023","unstructured":"El-Shehaby AMNReda WAAbdel Karim KMNabeel AMEmad Eldin RMTawadros SR.Single-session stereotactic radiosurgery for large perioptic meningiomas. J Neurosurg. 2023;139(3):780-789."},{"issue":"4","key":"bib13","series-title":"J Neurosurg","first-page":"1070","article-title":"Clinical and radiologic outcomes after stereotactic radiosurgery for meningiomas in direct contact with the optic apparatus: an international multicenter study","volume":"136","author":"Asuzu","year":"2022","unstructured":"Asuzu DTBunevicius AKormath Anand RClinical and radiologic outcomes after stereotactic radiosurgery for meningiomas in direct contact with the optic apparatus: an international multicenter study. J Neurosurg. 2022;136(4):1070-1076."},{"key":"bib14","series-title":"World Neurosurg","first-page":"e726","article-title":"Visual outcomes in spheno-orbital meningioma: a 10-year experience","volume":"158","author":"Kim","year":"2022","unstructured":"Kim RBFredrickson VLCouldwell WT.Visual outcomes in spheno-orbital meningioma: a 10-year experience. World Neurosurg. 2022;158:e726-e734."},{"issue":"suppl","key":"bib1","series-title":"J Neurosurg","first-page":"102","article-title":"Multisession Gamma Knife surgery for benign orbital tumors","volume":"117","author":"Jo","year":"2012","unstructured":"Jo KIIm YSKong DSMultisession Gamma Knife surgery for benign orbital tumors. J Neurosurg. 2012;117(suppl):102-107."},{"issue":"6","key":"bib2","series-title":"J Neurosurg","first-page":"951","article-title":"Surgical management of meningiomas involving the optic nerve sheath","volume":"101","author":"Schick","year":"2004","unstructured":"Schick UDott UHassler W.Surgical management of meningiomas involving the optic nerve sheath. J Neurosurg. 2004;101(6):951-959."},{"issue":"5","key":"bib3","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Meningiomas involving the optic canal: pattern of involvement and implications for surgical technique","volume":"30","author":"Taha","year":"2011","unstructured":"Taha ANMErkmen KDunn IFPravdenkova SAl-Mefty O.Meningiomas involving the optic canal: pattern of involvement and implications for surgical technique. Neurosurg Focus. 2011;30(5):E12."},{"issue":"4","key":"bib4","series-title":"J Neurosurg","first-page":"1044","article-title":"Sphenoorbital meningioma: a unique skull base tumor. Surgical technique and results","volume":"133","author":"Kiyofuji","year":"2020","unstructured":"Kiyofuji SCasabella AMGraffeo CSPerry AGarrity JALink MJ.Sphenoorbital meningioma: a unique skull base tumor. Surgical technique and results. J Neurosurg. 2020;133(4):1044-1051."},{"key":"bib5","series-title":"J Clin Neurosci","first-page":"409","article-title":"Clinical outcomes of fractionated stereotactic radiosurgery in treating perioptic meningiomas and schwannomas: a single-institutional experience","volume":"81","author":"Chen","year":"2020","unstructured":"Chen HYChuang CCChen HCClinical outcomes of fractionated stereotactic radiosurgery in treating perioptic meningiomas and schwannomas: a single-institutional experience. J Clin Neurosci. 2020;81:409-415."},{"issue":"2","key":"bib6","series-title":"Neurosurgery","first-page":"285","article-title":"Long-term tumor control and functional outcome in patients with cavernous sinus meningiomas treated by radiotherapy with or without previous surgery: is there an alternative to aggressive tumor removal?","volume":"48","author":"Dufour","year":"2001","unstructured":"Dufour HMuracciole XM\u00e9tellus PR\u00e9gis JChinot OGrisoli F.Long-term tumor control and functional outcome in patients with cavernous sinus meningiomas treated by radiotherapy with or without previous surgery: is there an alternative to aggressive tumor removal? Neurosurgery. 2001;48(2):285-296."},{"issue":"4","key":"bib7","series-title":"Neurosurgery","first-page":"828","article-title":"Stereotactic radiosurgery for perioptic meningiomas: an international, multicenter study","volume":"88","author":"Bunevicius","year":"2021","unstructured":"Bunevicius AAnand RKSuleiman MStereotactic radiosurgery for perioptic meningiomas: an international, multicenter study. Neurosurgery. 2021;88(4):828-837."},{"issue":"1","key":"bib8","series-title":"Int J Radiat Oncol Biol Phys","first-page":"87","article-title":"Single- and multi-fraction stereotactic radiosurgery dose tolerances of the optic pathways","volume":"110","author":"Milano","year":"2021","unstructured":"Milano MTGrimm JSoltys SGSingle- and multi-fraction stereotactic radiosurgery dose tolerances of the optic pathways. Int J Radiat Oncol Biol Phys. 2021;110(1):87-99."},{"issue":"5","key":"bib9","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1177","article-title":"A study on the radiation tolerance of the optic nerves and chiasm after stereotactic radiosurgery","volume":"55","author":"Stafford","year":"2003","unstructured":"Stafford SLPollock BELeavitt JAA study on the radiation tolerance of the optic nerves and chiasm after stereotactic radiosurgery. Int J Radiat Oncol Biol Phys. 2003;55(5):1177-1181."},{"issue":"suppl 2","key":"bib10","series-title":"Neuro-Oncol","first-page":"ii122","article-title":"P18.03. A hypofractionation with optimized stereotactic radiosurgery planning for skull base perioptic meningiomas","volume":"25","author":"Cho","year":"2023","unstructured":"Cho YYoon KLee DP18.03. A hypofractionation with optimized stereotactic radiosurgery planning for skull base perioptic meningiomas. Neuro-Oncol. 2023;25(suppl 2):ii122."},{"issue":"3","key":"bib11","series-title":"J Neurooncol","first-page":"679","article-title":"Clinical outcomes of perioptic tumors treated with hypofractionated stereotactic radiotherapy using CyberKnife\u00ae stereotactic radiosurgery","volume":"139","author":"Puataweepong","year":"2018","unstructured":"Puataweepong PDhanachai MHansasuta AClinical outcomes of perioptic tumors treated with hypofractionated stereotactic radiotherapy using CyberKnife\u00ae stereotactic radiosurgery. J Neurooncol. 2018;139(3):679-688."},{"issue":"3","key":"bib12","series-title":"J Neurosurg","first-page":"780","article-title":"Single-session stereotactic radiosurgery for large perioptic meningiomas","volume":"139","author":"El-Shehaby","year":"2023","unstructured":"El-Shehaby AMNReda WAAbdel Karim KMNabeel AMEmad Eldin RMTawadros SR.Single-session stereotactic radiosurgery for large perioptic meningiomas. J Neurosurg. 2023;139(3):780-789."},{"issue":"4","key":"bib13","series-title":"J Neurosurg","first-page":"1070","article-title":"Clinical and radiologic outcomes after stereotactic radiosurgery for meningiomas in direct contact with the optic apparatus: an international multicenter study","volume":"136","author":"Asuzu","year":"2022","unstructured":"Asuzu DTBunevicius AKormath Anand RClinical and radiologic outcomes after stereotactic radiosurgery for meningiomas in direct contact with the optic apparatus: an international multicenter study. J Neurosurg. 2022;136(4):1070-1076."},{"key":"bib14","series-title":"World Neurosurg","first-page":"e726","article-title":"Visual outcomes in spheno-orbital meningioma: a 10-year experience","volume":"158","author":"Kim","year":"2022","unstructured":"Kim RBFredrickson VLCouldwell WT.Visual outcomes in spheno-orbital meningioma: a 10-year experience. World Neurosurg. 2022;158:e726-e734."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/15\/article-CASE2530.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/15\/article-CASE2530.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/15\/article-CASE2530.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:40:20Z","timestamp":1770075620000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/15\/article-CASE2530.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,14]]},"references-count":28,"journal-issue":{"issue":"15"},"URL":"https:\/\/doi.org\/10.3171\/case2530","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,14]]}}}