Meningioma and cavernous angioma following childhood radiotherapy

Abstract

Prophylactic cranial irradiation has been a part of multimodality management of acute lymphoblastic leukemia (ALL). With optimum treatment and the resultant long-term cure rates, long-term side effects of radiation including radiation-induced neoplasms have been increasingly unearthed. We report a rare case of development of both a meningioma and a cavernous angioma following prophylactic cranial irradiation as a part of treatment of ALL. Regular follow-up and high index of suspicion for late radiation sequelae after treatment are therefore justifiable in leukemia survivors with history of prophylactic cranial irradiation.

Cavernous Hemangioma of the Skull and Meningioma: Association or Coincidence?

“…Meningiomas arise from meningothelial cells of the arachnoid layer that forms the external lining of the brain and occur primarily at the base of the skull in the parasellar regions as well as over the cerebral convexities [ 7 ]. Meningiomas may be categorized as benign (90%), atypical/borderline (5%), and malignant (3–5%); within the benign category, there are several subtypes, including syncytial, fibrous, and transitional [ 8 ].…”

“…Very few reports mention the coexistence of vascular lesions and meningioma in the same patient [ 7 – 10 ]. To our knowledge, we report the first case of a calvarial cavernous hemangioma located nearby a meningioma.…”

“…Exposure to ionizing radiation has been implicated as an etiology for brain tumors like meningiomas and cavernous hemangiomas, gliomas, and sarcomas [ 7 ]. Radiation-induced neoplasms often develop as a result of mutagenic capacity, chromosome aberration, and DNA injury caused by the radiation.…”

Meningeome

“…B. 8 Gy zur Behandlung von Tinea capitis in Israel der 1950er-Jahre) mit einer Latenzzeit von 35 Jahren (9), dann sehr oft atypische Meningeome mit hohen Proliferationsindizes (10). Obwohl Meningeome sehr häufig Progesteron-und Östrogenrezeptoren exprimieren und Frauen dreimal häufiger Meningeome entwickeln und obwohl die Koinzidenz zwischen Brustkrebs und Meningeomen akzeptiert ist, konnte kein Zusammenhang außerhalb der Grundlagenforschung, zwischen dem Auftreten von Meningeomen und einer hormonellen Stimulation gefunden werden (11,12).…”

Brain Cavernomas Induced By Radiotherapy in the Patient With Acute Lymphocytic Leukemia (ALL)

“…Radiotherapy is considered the main part of the curative and preventive regimes in the pediatric cancer especially has been highly used in acute lymphocytic leukemia (ALL) as prophylaxis (1,2). A large number of the radiotherapy secondary delayed effects have been well known.…”