{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:08:28Z","timestamp":1776096508496,"version":"3.50.1"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"15","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"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 Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,4,13]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Metastatic ameloblastoma with skull base or intracranial involvement is exceedingly rare, and optimal local therapy is not well defined when complete resection is infeasible or morbid. Stereotactic radiosurgery (SRS) may offer focal control for complex skull base targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A patient with ameloblastoma underwent six prior resections at an outside institution (2010, 2011, 2015, 2018, 2021, and November 2024) before developing multicompartment skull base progression involving the cavernous sinus\u2013sellar region and the infratemporal fossa\u2013right lateral orbital region. SRS (Gamma Knife radiosurgery) was delivered in a staged (sequenced) manner to anatomically distinct targets over time, treating the cavernous sinus\u2013sellar component in November 2024 and the recurrent lesion lateral to the right orbit in April 2025. The cavernous sinus\u2013sellar target received 13 Gy (50% isodose), and the second target received 14 Gy (50% isodose). Follow-up imaging demonstrated marked volumetric response (\u221293% and \u2212100%, respectively), with clinical improvement and no clinically identified adverse radiation effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>In selected patients with heavily pretreated metastatic ameloblastoma, staged SRS to different skull base compartments can provide durable local control while limiting morbidity. Radiosurgical sequencing may preserve future options in a longitudinal disease course and underscores the need for long-term imaging surveillance.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE2651\">https:\/\/thejns.org\/doi\/10.3171\/CASE2651<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case2651","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T15:27:35Z","timestamp":1776094055000},"source":"Crossref","is-referenced-by-count":0,"title":["Staged Gamma Knife radiosurgery for multicompartment skull base metastatic ameloblastoma: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Deniz","family":"K\u0131l\u0131\u00e7","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Bah\u00e7e\u015fehir University Faculty of Medicine, Istanbul"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ak\u0131n","family":"Akak\u0131n","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Bah\u00e7e\u015fehir University Faculty of Medicine, Istanbul"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat \u015eakir","family":"Ek\u015fi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, \u0130stinye University Faculty of Medicine, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T\u00fcrker","family":"K\u0131l\u0131\u00e7","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, \u0130stinye University Faculty of Medicine, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"Acta Chir Scand","first-page":"316","article-title":"The stereotaxic method and radiosurgery of the brain","volume":"102","author":"Leksell","year":"1951","unstructured":"Leksell L.The stereotaxic method and radiosurgery of the brain. Acta Chir Scand. 1951;102(4):316-319."},{"issue":"suppl 2","key":"bib2","series-title":"Surg Neurol","first-page":"S58","article-title":"Changing treatment strategy of cavernous sinus meningiomas: experience of a single institution","volume":"64","author":"Pamir","year":"2005","unstructured":"Pamir MNKili\u00e7 TBayrakli FPeker S.Changing treatment strategy of cavernous sinus meningiomas: experience of a single institution. Surg Neurol. 2005;64(suppl 2):S58-S66. doi:10.1016\/J.SURNEU.2005.07.053"},{"issue":"2","key":"bib3","series-title":"Neurosurgery","first-page":"270","article-title":"Pituitary adenomas treated with Gamma Knife radiosurgery: volumetric analysis of 100 cases with minimum 3-year follow-up","volume":"61","author":"Pamir","year":"2007","unstructured":"Pamir MNKili\u00e7 TBelirgen MAbaciog\u02c7lu UKarabekirog\u02c7lu N.Pituitary adenomas treated with Gamma Knife radiosurgery: volumetric analysis of 100 cases with minimum 3-year follow-up. Neurosurgery. 2007;61(2):270-280. doi:10.1227\/01.NEU.0000255519.96837.C7"},{"issue":"4","key":"bib4","series-title":"J Clin Neurosci","first-page":"441","article-title":"Gamma Knife stereotactic radiosurgery yields good long-term outcomes for low-volume uveal melanomas without intraocular complications","volume":"17","author":"Toktas","year":"2010","unstructured":"Toktas ZOBicer ADemirci GGamma Knife stereotactic radiosurgery yields good long-term outcomes for low-volume uveal melanomas without intraocular complications. J Clin Neurosci. 2010;17(4):441-445. doi:10.1016\/j.jocn.2009.08.004"},{"issue":"3","key":"bib5","series-title":"Balk Med J","first-page":"167","article-title":"Ectopic pituitary neuroendocrine tumors\/adenomas around the sella turcica","volume":"41","author":"Demir","year":"2024","unstructured":"Demir MKErtem \u00d6K\u0131l\u0131\u00e7 DEctopic pituitary neuroendocrine tumors\/adenomas around the sella turcica. Balk Med J. 2024;41(3):167-173. doi:10.4274\/BALKANMEDJ.GALENOS.2024.2023-11-90"},{"issue":"8","key":"bib6","series-title":"Int J Oral Maxillofac Surg","first-page":"934","article-title":"The use of Gamma Knife stereotactic radiosurgery in the treatment of ameloblastic carcinoma","volume":"42","author":"Perera","year":"2013","unstructured":"Perera ELindquist CHughes CThomas S.The use of Gamma Knife stereotactic radiosurgery in the treatment of ameloblastic carcinoma. Int J Oral Maxillofac Surg. 2013;42(8):934-938. doi:10.1016\/j.ijom.2013.04.015"},{"issue":"5","key":"bib7","series-title":"J Oral Maxillofac Surg Med Pathol","first-page":"1000","article-title":"Malignant transformation of ameloblastoma: a case report and literature review","volume":"37","author":"Wang","year":"2025","unstructured":"Wang JWang BDai JMalignant transformation of ameloblastoma: a case report and literature review. J Oral Maxillofac Surg Med Pathol. 2025;37(5):1000-1008. doi:10.1016\/j.ajoms.2025.03.003"},{"issue":"10","key":"bib8","series-title":"J Neurosurg Case Lessons","first-page":"CASE23264","article-title":"Rare solitary pituitary metastasis of maxillary ameloblastic carcinoma: illustrative case","volume":"6","author":"Arikawa","year":"2023","unstructured":"Arikawa SWatanabe TYamaguchi HRare solitary pituitary metastasis of maxillary ameloblastic carcinoma: illustrative case. J Neurosurg Case Lessons. 2023;6(10):CASE23264. doi:10.3171\/case23264"},{"issue":"4","key":"bib9","series-title":"Austin J Clin Case Rep","first-page":"id1205","article-title":"Gamma Knife for recurrent ameloblastoma with cavernous sinus metastasis: a case report","volume":"8","author":"He","year":"2021","unstructured":"He BYang SLi D.Gamma Knife for recurrent ameloblastoma with cavernous sinus metastasis: a case report. Austin J Clin Case Rep. 2021;8(4):id1205."},{"issue":"11","key":"bib10","series-title":"J Clin Oncol","first-page":"1963","article-title":"Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group","volume":"28","author":"Wen","year":"2010","unstructured":"Wen PYMacdonald DRReardon DAUpdated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28(11):1963-1972. doi:10.1200\/JCO.2009.26.3541"},{"issue":"6","key":"bib11","series-title":"Lancet Oncol","first-page":"e270","article-title":"Response assessment criteria for brain metastases: proposal from the RANO group","volume":"16","author":"Lin","year":"2015","unstructured":"Lin NULee EQAoyama HResponse assessment criteria for brain metastases: proposal from the RANO group. 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Balk Med J. 2024;41(3):167-173. doi:10.4274\/BALKANMEDJ.GALENOS.2024.2023-11-90"},{"issue":"8","key":"bib6","series-title":"Int J Oral Maxillofac Surg","first-page":"934","article-title":"The use of Gamma Knife stereotactic radiosurgery in the treatment of ameloblastic carcinoma","volume":"42","author":"Perera","year":"2013","unstructured":"Perera ELindquist CHughes CThomas S.The use of Gamma Knife stereotactic radiosurgery in the treatment of ameloblastic carcinoma. Int J Oral Maxillofac Surg. 2013;42(8):934-938. doi:10.1016\/j.ijom.2013.04.015"},{"issue":"5","key":"bib7","series-title":"J Oral Maxillofac Surg Med Pathol","first-page":"1000","article-title":"Malignant transformation of ameloblastoma: a case report and literature review","volume":"37","author":"Wang","year":"2025","unstructured":"Wang JWang BDai JMalignant transformation of ameloblastoma: a case report and literature review. 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