# Stereotactic radiosurgery for residual rosette-forming glioneuronal tumor: a case report and literature review

## TL;DR

This case report shows that stereotactic radiosurgery can effectively treat a residual rosette-forming glioneuronal tumor, offering long-term control without worsening the patient's condition.

## Contribution

The paper presents a novel case of successful SRS treatment for residual RGNT, suggesting its potential as a durable therapy.

## Key findings

- The patient experienced radiologic tumor regression and symptom resolution after SRS.
- The patient remained neurologically intact for 66 months post-treatment.
- SRS may be a safe and effective treatment for residual RGNT when complete resection is not possible.

## Abstract

Rosette-forming glioneuronal tumors (RGNT) are rare and novel World Health Organization grade I neoplasms that typically arise in the fourth ventricle and progress slowly. Surgical resection is the standard treatment. However, owing to their adherence to critical structures, complete resection is often not possible. The role of stereotactic radiosurgery (SRS) in the management of RGNT remains inconclusive. We present a case of tissue-confirmed RGNT successfully treated with SRS. A 24-year-old woman presented with diplopia and dysequilibrium and was subsequently diagnosed with a fourth ventricular tumor. Subtotal resection was performed at another hospital, and a tissue-based diagnosis of RGNT was made. After a multidisciplinary discussion and following the patient’s willingness, single-session SRS was prescribed at a marginal dose of 12 Gy. During the subsequent 66-month follow-up period, radiologic regression of the tumor with corresponding resolution of symptoms was noted. She remained neurologically intact at her last official visit. The treatment paradigm for residual RGNT remains elusive due to its scarcity and varied presentation. We have presented our preliminary experience with a residual RGNT that was managed with SRS, attaining long-term freedom from tumor progression. SRS may be a safe, effective, and durable treatment modality for patients with RGNT.