Medical Radiology and Radiation Safety. 2025. Vol. 70. № 3

DOI:10.33266/1024-6177-2025-70-3-90-98

K.V. Koval, A.S. Tokarev, A.A. Kanibolotskiy, O.L. Evdokimova, A.A. Grin 

Pathomorphological Changes in Cell Structures of Cerebral Metastasis of Lung Adenocarcinoma after Neoadjuvant Gamma Knife Radiosurgy. A Case Report

N.V. Sklifosovsky Scientific Research Institute of First Aid, Moscow, Russia

Contact person: K.V. Koval, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Abstract

Purpose: To identify and describe morphological changes in the cells of lung adenocarcinoma metastasis to the brain after preoperative (neoadjuvant) Gamma Knife radiosurgery.

Material and methods: A 63-year-old female patient with brain metastases of lung adenocarcinoma including large metastasis in the right frontal lobe. Neoadjuvant stereotactic radiosurgery was performed by Leksell Gamma Knife Icon. Histological and immunohistochemical studies were performed after microsurgical removal of the metastasis in the right frontal lobe. The analysis of scanned images was performed using the NDP.view2 program of the Image Viewing software (© Hamamatsu Photonics K.K.).

Results: The result of histological and immunohistochemical studies is TTF-I+, ROS- lung adenocarcinoma. The most significant changes were coagulation necrosis, vasculopathy, altered blood vessels with endothelial damage, affected cells with pyknotic nuclei, and islets of coagulation necrosis with cells of adenocarcinoma. Despite the descriptive characteristics of early post-radiation changes, apparently caused by radiosurgical exposure, the specific mechanism of post-radiation reactions occurring in malignant cells of cerebral metastases remains to be understood. It is necessary to include the series of cases, in particular, with subsequent analysis of ultramicroscopic findings obtained by electron microscopy.

Keywords: cerebral metastases, neoadjuvant radiosurgery, stereotactic radiosurgery, immunohistochemistry, molecular genetic testing, gamma knife

For citation: Koval KV, Tokarev AS, Kanibolotskiy AA, Evdokimova OL, Grin AA. Pathomorphological Changes in Cell Structures of Cerebral Metastasis of Lung Adenocarcinoma after Neoadjuvant Gamma Knife Radiosurgy. A Case Report. Medical Radiology and Radiation Safety. 2025;70(3):90–98. (In Russian). DOI:10.33266/1024-6177-2025-70-3-90-98

 

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.02.2025. Accepted for publication: 25.03.2025.