Successful stereotactic radiosurgery with the CyberKnife of a giant arteriovenous malformation of the tongue: a case report.

We report a successful outcome for a large arteriovenous malformation (AVM) of the tongue treated with CyberKnife (CK) image-based stereotactic radiosurgery (SRS). A 56-year-old man presenting with a tongue AVM underwent ligation of the lingual artery and partial resection of the nidus. Sixteen years later, his pulsating submandibular mass had enlarged. An image study revealed a remarkable re-expansion of the nidus involving the tongue and the oral floor, with a volume of 130 ml. CK SRS was performed with 2 fractions. The prescribed marginal dose was 22 Gy. Thirty-four months after SRS, angiography demonstrated complete obliteration of the nidus without major adverse effects. We conclude that CK SRS may be suitable for the treatment of AVMs in the head and neck region. 2009 S. Karger AG, Basel.