Subscribe to RSS
A Case of Suspected Radiation-Induced Meningioma That Developed 36 Years after Radiotherapy for a Suprasellar Tumor
Recently, the improvements in the prognosis of childhood brain tumors have made it necessary to consider the risk of radiation-induced brain tumor development in long-term survivors. In this report, we describe a case of radiation-induced meningioma (RIM) treated surgically 36 years after radiotherapy. A 46-year-old woman, who underwent craniotomy for suprasellar germ cell tumor at 10 years of age with additional postoperative radiotherapy, was admitted to the emergency room with consciousness disturbance and right hemiplegia. One year earlier, magnetic resonance imaging (MRI) revealed a 1-cm diameter tumor in the left middle cranial fossa. This MRI showed an enlarged brain tumor in same lesion with clearly enhanced by gadolinium. A RIM located on a left sphenoid ridge with a fast growth rate was diagnosed, and the gross total removal was achieved by a left frontotemporal craniotomy. Histological diagnosis of atypical meningioma (World Health Organization grade II) was made. RIMs are frequently atypical, anaplastic meningiomas that have already been treated with radiotherapy, making additional postoperative radiotherapy difficult; the removal rate must be increased to achieve a good prognosis. In the case of long-term survivors after childhood radiotherapy, a strict follow-up with the occurrence of RIM in mind is necessary.
Article published online:
28 October 2022
© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Al-Mefty O, Topsakal C, Pravdenkova S, Sawyer JR, Harrison MJ. Radiation-induced meningiomas: clinical, pathological, cytokinetic, and cytogenetic characteristics. J Neurosurg 2004; 100 (06) 1002-1013
- 2 Fujii M, Ichikawa M, Iwatate K. et al. Secondary brain tumors after cranial radiation therapy: a single-institution study. Rep Pract Oncol Radiother 2020; 25 (02) 245-249
- 3 Harrison MJ, Wolfe DE, Lau TS, Mitnick RJ, Sachdev VP. Radiation-induced meningiomas: experience at the Mount Sinai Hospital and review of the literature. J Neurosurg 1991; 75 (04) 564-574
- 4 Sadetzki S, Flint-Richter P, Ben-Tal T, Nass D. Radiation-induced meningioma: a descriptive study of 253 cases. J Neurosurg 2002; 97 (05) 1078-1082
- 5 Agnihotri S, Suppiah S, Tonge PD. et al. Therapeutic radiation for childhood cancer drives structural aberrations of NF2 in meningiomas. Nat Commun 2017; 8 (01) 186
- 6 Endo H, Kumabe T, Jokura H, Tominaga T. Stereotactic radiosurgery followed by whole ventricular irradiation for primary intracranial germinoma of the pineal region. Minim Invasive Neurosurg 2005; 48 (03) 186-190
- 7 Strojan P, Popović M, Jereb B. Secondary intracranial meningiomas after high-dose cranial irradiation: report of five cases and review of the literature. Int J Radiat Oncol Biol Phys 2000; 48 (01) 65-73
- 8 Mack EE, Wilson CB. Meningiomas induced by high-dose cranial irradiation. J Neurosurg 1993; 79 (01) 28-31
- 9 Umansky F, Shoshan Y, Rosenthal G, Fraifeld S, Spektor S. Radiation-induced meningioma. Neurosurg Focus 2008; 24 (05) E7 DOI: 10.3171/FOC/2008/24/5/E7.
- 10 Puchner MJA, Hans VH, Harati A, Lohmann F, Glas M, Herrlinger U. Bevacizumab-induced regression of anaplastic meningioma. Ann Oncol 2010; 21 (12) 2445-2446
- 11 Kondziolka D, Kano H, Kanaan H. et al. Stereotactic radiosurgery for radiation-induced meningiomas. Neurosurgery 2009; 64 (03) 463-469 , discussion 469–470