Brain Tumor Res Treat.  2015 Oct;3(2):156-159. 10.14791/btrt.2015.3.2.156.

A Case of Radiation-Induced Osteosarcoma after the Treatment of Pineoblastoma

• Hong N
• Yoo H
• Shin SH
• Gwak HS
• Lee SH

• KMID: 2114666
• DOI: http://doi.org/10.14791/btrt.2015.3.2.156

Abstract

Radiation therapy has an important role in postoperative treatment of neoplasms originated from central nervous system, but may induce secondary malignancies like as sarcomas, gliomas, and meningiomas. The prognosis of radiation-induced osteosarcomas is known as poor, because they has aggressive nature invasive locally and intractable to multiple treatment strategies like as surgical resection, chemotherapy, and so on. We report a case of radiation-induced osteosarcoma developed from skull after 7 years of craniospinal radiotherapy for pineoblastoma.

Keyword

Radiation; Osteosarcoma; Irradiation; Skull; Pineoblastoma

MeSH Terms

Central Nervous System
Drug Therapy
Glioma
Meningioma
Osteosarcoma*
Pinealoma*
Prognosis
Radiotherapy
Sarcoma
Skull

Figure

• 

  Fig. 1 Radiation treatment plan.

• 

  Fig. 2 Pathologic finding of tumor specimen. There were two parts, dura and scalp. A and B were removed from epidural layer including dura mater (A: H&E, ×4, B: H&E, ×200). The features shown that pleomorphic single cells with abundant cytoplasm and prominent nucleoli, osteoid production are compatible with osteoblastic osteosarcoma. H&E, hematoxylin and eosin.

• 

  Fig. 3 T1-weighted MRI with gadolinium-enhancement shows irregular enhancing mass at mainly Rt. frontal area and extending to contralateral side. A, B, and C are each applicable to axial, coronal, and sagittal view.

Reference

1. Munk J, Peyser E, Gruszkiewicz J. Radiation induced intracranial meningiomas. Clin Radiol. 1969; 20:90–94.

2. Sale KA, Wallace DI, Girod DA, Tsue TT. Radiation-induced malignancy of the head and neck. Otolaryngol Head Neck Surg. 2004; 131:643–645.

3. Prasad G, Haas-Kogan DA. Radiation-induced gliomas. Expert Rev Neurother. 2009; 9:1511–1517.

4. Amendola BE, Amendola MA, McClatchey KD, Miller CH Jr. Radiation-associated sarcoma: a review of 23 patients with postradiation sarcoma over a 50-year period. Am J Clin Oncol. 1989; 12:411–415.

5. Taghian A, de Vathaire F, Terrier P, et al. Long-term risk of sarcoma following radiation treatment for breast cancer. Int J Radiat Oncol Biol Phys. 1991; 21:361–367.

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.

7. Arlen M, Higinbotham NL, Huvos AG, et al. Radiation-induced sarcoma of bone. Cancer. 1971; 28:1087–1099.

8. Robinson E, Neugut AI, Wylie P. Clinical aspects of postirradiation sarcomas. J Natl Cancer Inst. 1988; 80:233–240.

9. Brenin CM, Small W Jr, Talamonti MS, Gradisher WJ. Radiation-Induced Sarcoma Following Treatment of Breast Cancer. Cancer Control. 1998; 5:425–432.

10. Cantini R, Burchianti M, Fabrini MG, Valleriani AM, Simi U. Postirradiation meningioma. Childs Nerv Syst. 1987; 3:382–384.

11. Okamoto S, Handa H, Yamashita J, Tokuriki Y, Abe M. Post-irradiation brain tumors. Neurol Med Chir (Tokyo). 1985; 25:528–533.

12. Watanabe T, Fuse T, Umezu M, Yamamoto M, Demura K, Niwa Y. Radiation-induced osteosarcoma 16 years after surgery and radiation for glioma--case report. Neurol Med Chir (Tokyo). 2006; 46:51–54.

13. Ito T, Ozaki Y, Sato K, et al. Radiation-induced osteosarcomas after treatment for frontal gliomas: a report of two cases. Brain Tumor Pathol. 2010; 27:103–109.

14. Domenicucci M, Artico M, Nucci F, Salvati M, Ferrante L. Meningioma following high-dose radiation therapy. Case report and review of the literature. Clin Neurol Neurosurg. 1990; 92:349–352.

15. Salvati M, Artico M, Caruso R, Rocchi G, Orlando ER, Nucci F. A report on radiation-induced gliomas. Cancer. 1991; 67:392–397.

16. Salvati M, Cervoni L, Ciappetta P, Raco A. Radiation-induced osteosarcomas of the skull: report of two cases and review of the literature. Clin Neurol Neurosurg. 1994; 96:226–229.

17. Chan LL, Czerniak BA, Ginsberg LE. Radiation-induced osteosarcoma after bilateral childhood retinoblastoma. AJR Am J Roentgenol. 2000; 174:1288.

18. Skolnik EM, Fornatto EJ, Heydemann J. Osteogenic sarcoma of the skull following irradiation. Ann Otol Rhinol Laryngol. 1956; 65:914–936.

19. Sugita Y, Shigemori M, Miyagi J, et al. Radiation-induced osteosarcoma of the calvaria--case report. Neurol Med Chir (Tokyo). 1992; 32:32–35.

20. Sparagana M, Eells RW, Stefani S, Jablokow V. Osteogenic sarcoma of the skull: a rare sequela of pituitary irradition. Cancer. 1972; 29:1376–1379.

21. Tanaka S, Nishio S, Morioka T, Fukui M, Kitamura K, Hikita K. Radiation-induced osteosarcoma of the sphenoid bone. Neurosurgery. 1989; 25:640–643.

22. Kellie SJ, Hutchison RE, Robertson JT, Pratt CB. Successful treatment of a radiation-associated extradural osteosarcoma with chemotherapy in an adolescent girl. Med Pediatr Oncol. 1989; 17:514–519.