J Korean Med Sci.  2017 Nov;32(11):1896-1902. 10.3346/jkms.2017.32.11.1896.

Coexistence of Radiation-Induced Meningioma and Moyamoya Syndrome 10 Years after Irradiation against Medulloblastoma: a Case Report

Affiliations
  • 1Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 2Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea. nsthomas@snu.ac.kr
  • 3Department of Anatomy, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 4Division of Pediatric Neurology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Pathology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 6Division of Pediatric Radiology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Radiotherapy is one of the standard treatments for medulloblastoma. However, therapeutic central nervous system irradiation in children may carry delayed side effects, such as radiation-induced tumor and vasculopathy. Here, we report the first case of coexisting meningioma and moyamoya syndrome, presenting 10 years after radiotherapy for medulloblastoma. A 13-year-old boy presented with an enhancing mass at the cerebral falx on magnetic resonance imaging (MRI) after surgery, radiotherapy (30.6 Gy craniospinal axis, 19.8 Gy posterior fossa) and chemotherapy against medulloblastoma 10 years ago, previously. The second tumor was meningioma. On postoperative day 5, he complained of right-sided motor weakness, motor dysphasia, dysarthria, and dysphagia. MRI revealed acute cerebral infarction in the left frontal lobe and both basal ganglia. MR and cerebral angiography confirmed underlying moyamoya syndrome. Four months after the meningioma surgery, the patient presented with headaches, dysarthria, and dizziness. Indirect bypass surgery was performed. He has been free from headaches since one month after the surgery. For patients who received radiotherapy for medulloblastoma at a young age, clinicians should consider the possibility of the coexistence of several complications. Careful follow up for development of secondary tumor and delayed vasculopathy is required.

Keyword

Meningioma; Moyamoya Syndrome; Medulloblastoma; Radiation-Induced Vasculopathy; Radiation-Induced Tumor; Radiotherapy

MeSH Terms

Adolescent
Aphasia
Basal Ganglia
Central Nervous System
Cerebral Angiography
Cerebral Infarction
Child
Deglutition Disorders
Dizziness
Drug Therapy
Dysarthria
Follow-Up Studies
Frontal Lobe
Headache
Humans
Magnetic Resonance Imaging
Male
Medulloblastoma*
Meningioma*
Moyamoya Disease*
Radiotherapy
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr