Anaplastic Astrocytomas Associated with Previous Radiotherapy: Report of Three Cases

Dierssen, G; Alvarez, Gustavo Benitez; Figols, J.

doi:10.1227/00006123-198806010-00024

Cited by 26 publications

(11 citation statements)

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“…That radiation may be implicated as a cause of human CNS gliomas is demonstrated by those patients who developed gliomas in the field of radiation at a rate higher than expected after receiving radiothera py for relatively benign conditions such as tinea capitis and pituitary tumors [11,14,[24][25][26][27][28][29][30][31][32][33][34][35][36]. Most radiationinduced intracranial gliomas have occurred following more than 3,000 rad [37-44], Criteria for defining a hu man neoplasm as radiation-induced are a long quiescent latent period, a location within the irradiated area and a tumor distinctly different from the lesion for which the patient was irradiated [11,29,34].…”

Section: Effects Of Cns Prophylaxismentioning

confidence: 99%

Late Anaplastic Gliomas in Children Previously Treated for Acute Lymphoblastic Leukemia

Shapiro

Mealey

1989

Pediatr Neurosurg

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At least 33 cases of late anaplastic gliomas in children previously treated for acute lymphoblastic leukemia have been discussed in the literature including 20 well-documented cases. The frequency of this second malignancy is much greater than expected and may represent a ‘new syndrome’ with some genetic predisposition. Additionally, CNS prophylaxis which includes both radiation and intrathecal methotrexate appears to work synergistically in increasing the incidence of glial tumors especially multifocal tumors in these patients. The prognosis for these children is dismal but an aggressive treatment approach including surgery, interstitial radiation, and chemotherapy appears to improve survival.

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Section: Effects Of Cns Prophylaxismentioning

confidence: 99%

Late Anaplastic Gliomas in Children Previously Treated for Acute Lymphoblastic Leukemia

Shapiro

Mealey

1989

Pediatr Neurosurg

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“…7,11) Malignant transformation was confirmed within 3 years in two cases. 3) The patient backgrounds and therapeutic strategies differed in each case, but four of six patients (excluding six unknown cases) survived for less than 36 months. 3,7) The course of radiation-induced astrocytoma tends to be dismal, even with an initial histological diagnosis of astrocytoma.…”

Section: Discussionmentioning

confidence: 98%

“…Twelve cases of radiation-induced grade II astrocytoma are summarized in Table 1. [1][2][3]5,7,[10][11][12][13] The mean age was 25.7 years, and the male/female ratio was 7:5. The reason for first irradiation included acute lymphocytic leukemia (n ＝ 5), tinea capitis (n ＝ 3), germ cell tumor (n ＝ 1), medulloblastoma (n ＝ 1), meningioma (n ＝ 1), and chronic ear infection (n ＝ 1).…”

Section: Discussionmentioning

confidence: 99%

Radiation-Induced Astrocytoma With Rapid Malignant Transformation -Case Report-

Komatsu

Kawaguchi

Tsugu

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 23-year-old man was admitted with a rare case of radiation-induced astrocytoma manifesting as 3-month history of unstable gait. He had received 50 Gy of irradiation therapy for a germ cell tumor in the right basal ganglia 13 years earlier. Magnetic resonance (MR) imaging on admission showed a non-enhanced mass lesion in the right cerebellar hemisphere with expansion to the vermis. The histological diagnosis of the stereotaxic biopsy specimen was grade II astrocytoma. Two months later, he developed drowsiness, and MR imaging demonstrated that the tumor had enlarged and was enhanced after gadolinium injection. The clinical diagnosis was high-grade glioma resulting from malignant transformation. The tumor had compressed the mesencephalic aqueduct, leading to obstructive hydrocephalus. Endoscopic third ventriculostomy was performed to improve the cerebrospinal fluid circulation. He underwent chemotherapy with temozolomide postoperatively, but died 8 months after the initial diagnosis of astrocytoma. The clinical course of radiation-induced astrocytoma is not benign. The potential for malignant transformation necessitates careful postoperative follow up for patients with this tumor.

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“…The three intracerebral secondary tumours have developed after RT for intracranial tumours, and all were situated at the edge of the irradiated volume. It has been found that patients with radiation-induced gliomas are often clearly younger than other patients who spontaneously develop gliomas [50]. In a review of 30 reports on gliomas after RT for pituitary adenoma or CP, Simmons and Laws [28] found young age, high histological grade and occurrence within the temporal lobe as typical features for the secondary tumours.…”

Section: Discussionmentioning

confidence: 99%

Malignant Glioma as a Secondary Malignant Neoplasm after Radiation Therapy for Craniopharyngioma. Report of a Case and Review of Reported Cases

Kranzinger

Jones²,

Rittinger³

et al. 2001

Oncol Res Treat

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Background: The development of a secondary neoplasm in childhood cancer survivors attains growing importance due to the reported excellent survival and therefore the long exposure to potentially carcinogenic effects of treatment. Case Report: We report a 14-year-old girl in whom a large craniopharyngioma (CP) was diagnosed. After surgery, radiation therapy (RT) was given for residual tumour. Discrete progression necessitated further surgery, resulting in permanent tumour control. Soon after the second surgery hypothalamic-pituitary dysfunction developed together with obesity. Supportive hormone therapy was initiated. Growth hormone (GH) therapy was also given for 15 months. Four years after the diagnosis, a cerebropontine anaplastic astrocytoma WHO grade III was detected, with the main lesion being at the dorsal edge of the irradiated area. The girl died 1 month later from this secondary presumably radiation-induced tumour. Only recently a second child with RT for a CP was diagnosed with malignant glioma in our hospital. Case Reports in the Literature: 12 other cases of malignant glioma have been reported after RT for CP. Including our present cases, the mean latency period was 10.7 years (median 9.6 years). However, the shortest latency periods were found in patients who had received GH therapy. In numerous cases, the secondary tumour was seen at the edge of the irradiated volume, and not in the region with the highest absorbed dose. Conclusions: Therapy-induced secondary gliomas after treatment of CP or other intracranial tumours are rare but dramatic late events with a very poor prognosis. Including our own 2 patients, we reviewed 14 cases of CP with occurrence of a secondary, probably radiation-induced malignant glioma. The short latency periods for patients treated with GH is remarkable. We therefore suspect that GH therapy may accelerate the development of a secondary brain tumour. We are reluctant to recommend GH therapy in conventionally irradiated CP patients. In order to seriously answer the questions about therapy-induced secondary neoplasms, a life-long follow-up is mandatory for all patients who are survivors of childhood cancer.

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Anaplastic Astrocytomas Associated with Previous Radiotherapy: Report of Three Cases

Cited by 26 publications

References 0 publications

Late Anaplastic Gliomas in Children Previously Treated for Acute Lymphoblastic Leukemia

Late Anaplastic Gliomas in Children Previously Treated for Acute Lymphoblastic Leukemia

Radiation-Induced Astrocytoma With Rapid Malignant Transformation -Case Report-

Malignant Glioma as a Secondary Malignant Neoplasm after Radiation Therapy for Craniopharyngioma. Report of a Case and Review of Reported Cases

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