J Korean Neurosurg Soc.  2012 Feb;51(2):98-101. 10.3340/jkns.2012.51.2.98.

Glioblastoma Following Radiosurgery for Meningioma

Affiliations
  • 1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jilee@skku.edu

Abstract

We report a patient who underwent gamma knife radiosurgery to treat recurrent meningioma after microsurgery and thereafter developed secondary malignancy adjacent to the original tumor. A 47-year-old woman had underwent resection of the olfactory groove meningioma. Then radiosurgery was done three times over 4 year period for the recurrent tumor. After 58 months from the initial radiosurgery, she presented with headache and progressive mental dullness. Huge tumor in bifrontal location was revealed in MRI. Subsequent operation and pathological examination confirmed diagnosis of glioblastoma. This case fits the criteria of radiation-induced tumor and the clinical implication of the issue is discussed.

Keyword

Glioblastoma; Radiosurgery

MeSH Terms

Female
Glioblastoma
Headache
Humans
Meningioma
Microsurgery
Middle Aged
Radiosurgery

Figure

  • Fig. 1 T1-weighted contrast enhanced magnetic resonance image showing well enhanced frontal meningioma upon the olfactory groove.

  • Fig. 2 First Gamma Knife Surgery planning for meningioma which maximum radiating doses were 30 Gy on July 2004 (A) and 25 Gy on May 2007 (B) and 28 Gy on May 2009 (C).

  • Fig. 3 T1-weighted contrast enhanced magnetic resonance image demonstrating a mass with peripheral enhancement and central necrosis involving both frontal lobes with extension into the corpus callosum after 58 months from diagnosis of GM.

  • Fig. 4 Photomicrographs of the lesion demonstrate an infiltrating glial neoplasm comprised of highly atypical cells with pleomorphic angular nuclei and modest eosinophilic cytoplasm consistent with astrocytic lineage. Numerous mitoses and tumoral necrosis are present. This presentation is compatible with a glioblastoma.


Cited by  1 articles

Intradural Transpetrosectomy for Petrous Apex Meningiomas
Shuo Han, Xiao-Hua Zhang, Dong-Hua Han, Yi-Chao Jin
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Reference

1. Bari ME, Forster DM, Kemeny AA, Walton L, Hardy D, Anderson JR. Malignancy in a vestibular schwannoma. Report of a case with central neurofibromatosis, treated by both stereotactic radiosurgery and surgical excision, with a review of the literature. Br J Neurosurg. 2002; 16:284–289. PMID: 12201399.
Article
2. Bliss P, Kerr GR, Gregor A. Incidence of second brain tumours after pituitary irradiation in Edinburgh 1962-1990. Clin Oncol (R Coll Radiol). 1994; 6:361–363. PMID: 7873481.
Article
3. Boice JD Jr, Land CE, Shore RE, Norman JE, Tokunaga M. Risk of breast cancer following low-dose radiation exposure. Radiology. 1979; 131:589–597. PMID: 441361.
Article
4. Brada M, Ford D, Ashley S, Bliss JM, Crowley S, Mason M, et al. Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. BMJ. 1992; 304:1343–1346. PMID: 1611331.
Article
5. Cahan WG. Radiation-induced sarcoma--50 years later. Cancer. 1998; 82:6–7. PMID: 9428475.
Article
6. Cahan WG, Woodard HQ, Higinbotham NL, Stewart FW, Coley BL. Sarcoma arising in irradiated bone; report of 11 cases. Cancer. 1948; 1:3–29. PMID: 18867438.
7. Chang SM, Barker FG 2nd, Larson DA, Bollen AW, Prados MD. Sarcomas subsequent to cranial irradiation. Neurosurgery. 1995; 36:685–690. PMID: 7596497.
Article
8. Dodick DW, Mokri B, Shaw EG, Miller GM, Unni KK. Sarcomas of calvarial bones : rare remote effect of radiation therapy for brain tumors. Neurology. 1994; 44:908–912. PMID: 8190295.
Article
9. Epstein R, Hanham I, Dale R. Radiotherapy-induced second cancers : are we doing enough to protect young patients? Eur J Cancer. 1997; 33:526–530. PMID: 9274430.
Article
10. Kaido T, Hoshida T, Uranishi R, Akita N, Kotani A, Nishi N, et al. Radiosurgery-induced brain tumor. Case report. J Neurosurg. 2001; 95:710–713. PMID: 11596968.
11. Liwnicz BH, Berger TS, Liwnicz RG, Aron BS. Radiation-associated gliomas : a report of four cases and analysis of postradiation tumors of the central nervous system. Neurosurgery. 1985; 17:436–445. PMID: 2995867.
Article
12. McIver JI, Pollock BE. Radiation-induced tumor after stereotactic radiosurgery and whole brain radiotherapy : case report and literature review. J Neurooncol. 2004; 66:301–305. PMID: 15015661.
Article
13. Muracciole X, Régis J. Radiosurgery and carcinogenesis risk. Prog Neurol Surg. 2008; 21:207–213. PMID: 18810221.
Article
14. Nishio S, Morioka T, Fukui M. Radiation injury of the brain. Crit Rev Neurosurg. 1997; 7:408–415.
Article
15. Ron E, Modan B, Boice JD Jr, Alfandary E, Stovall M, Chetrit A, et al. Tumors of the brain and nervous system after radiotherapy in childhood. N Engl J Med. 1988; 319:1033–1039. PMID: 3173432.
Article
16. Sadetzki S, Flint-Richter P, Ben-Tal T, Nass D. Radiation-induced meningioma : a descriptive study of 253 cases. J Neurosurg. 2002; 97:1078–1082. PMID: 12450029.
17. Salvati M, Cervoni L, Puzzilli F, Bristot R, Delfini R, Gagliardi FM. High-dose radiation-induced meningiomas. Surg Neurol. 1997; 47:435–441. discussion 441-442. PMID: 9131025.
Article
18. Salvati M, Frati A, Russo N, Caroli E, Polli FM, Minniti G, et al. Radiation-induced gliomas : report of 10 cases and review of the literature. Surg Neurol. 2003; 60:60–67. discussion 67. PMID: 12865017.
19. Sanno N, Hayashi S, Shimura T, Maeda S, Teramoto A. Intracranial osteosarcoma after radiosurgery--case report. Neurol Med Chir (Tokyo). 2004; 44:29–32. PMID: 14959934.
Article
20. Shamisa A, Bance M, Nag S, Tator C, Wong S, Norén G, et al. Glioblastoma multiforme occurring in a patient treated with gamma knife surgery. Case report and review of the literature. J Neurosurg. 2001; 94:816–821. PMID: 11354416.
Article
21. Shin M, Ueki K, Kurita H, Kirino T. Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. Lancet. 2002; 360:309–310. PMID: 12147377.
Article
22. Soffer D, Pittaluga S, Feiner M, Beller AJ. Intracranial meningiomas following low-dose irradiation to the head. J Neurosurg. 1983; 59:1048–1053. PMID: 6631499.
Article
23. Thomsen J, Mirz F, Wetke R, Astrup J, Bojsen-Møller M, Nielsen E. Intracranial sarcoma in a patient with neurofibromatosis type 2 treated with gamma knife radiosurgery for vestibular schwannoma. Am J Otol. 2000; 21:364–370. PMID: 10821550.
Article
24. Tsang RW, Laperriere NJ, Simpson WJ, Brierley J, Panzarella T, Smyth HS. Glioma arising after radiation therapy for pituitary adenoma. A report of four patients and estimation of risk. Cancer. 1993; 72:2227–2233. PMID: 8374881.
Article
25. Tucker MA, D'Angio GJ, Boice JD Jr, Strong LC, Li FP, Stovall M, et al. Bone sarcomas linked to radiotherapy and chemotherapy in children. N Engl J Med. 1987; 317:588–593. PMID: 3475572.
Article
26. Yang T, Rockhill J, Born DE, Sekhar LN. A case of high-grade undifferentiated sarcoma after surgical resection and stereotactic radiosurgery of a vestibular schwannoma. Skull Base. 2010; 20:179–183. PMID: 21318035.
Article
27. Yu JS, Yong WH, Wilson D, Black KL. Glioblastoma induction after radiosurgery for meningioma. Lancet. 2000; 356:1576–1577. PMID: 11075777.
Article
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