Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma

Lew, Sean M.; Morgan, Joseph N.; Psaty, Estee; Lefton, Daniel R.; Allen, Jeffrey C.; Abbott, Rick

doi:10.3171/ped.2006.104.2.103

Cited by 51 publications

(61 citation statements)

References 19 publications

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“…Vascular telangiectasias are reported more frequently in patients after CNS irradiation. 25–27 Parenchymal radiation-associated MR imaging changes typically manifest as progressive, mild to moderate T2 prolongation in the periventricular white matter, 25 which may be the result of vascular abnormalities leading to parenchymal ischemia and white matter degeneration. It is not clear, however, whether similar mechanisms cause the white matter changes seen in older patients with A-T.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Abnormalities in Adults with Ataxia-Telangiectasia

Lin¹,

Barker²,

Lederman³

et al. 2013

AJNR Am J Neuroradiol

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SUMMARY: Ataxia-telangiectasia, an autosomal recessive disorder caused by defect of the ataxia-telangiectasia mutated gene, is characterized by progressive neurologic impairment with cerebellar atrophy, ocular and cutaneous telangiectasia, immunodeficiency, heightened sensitivity to ionizing radiation and susceptibility to developing lymphoreticular malignancy. Supratentorial brain abnormalities have been reported only rarely. In this study, brain MRI was performed in 10 adults with ataxia-telangiectasia having stable neurologic impairment. Intracerebral telangiectasia with multiple punctate hemosiderin deposits were identified in 60% of subjects. These lesions were apparently asymptomatic. They are similar in appearance to radiation-induced telangiectasia and to cryptogenic vascular malformations. Also noted, in the 2 oldest subjects, was extensive white matter T2 hyperintensity, and in 1 of these a space-occupying fluid collection consistent with transudative capillary leak and edema as evidenced by reduced levels of metabolites on MR spectroscopic imaging. Asymptomatic supratentorial vascular abnormalities appear to be common in adults with ataxia-telangiectasia.

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Section: Discussionmentioning

confidence: 99%

Cerebral Abnormalities in Adults with Ataxia-Telangiectasia

Lin¹,

Barker²,

Lederman³

et al. 2013

AJNR Am J Neuroradiol

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“…[3489] Venous restrictive disease has been postulated to be a consequence of impaired venous flow caused by radiation change. This impairment increases venous pressure and may lead to the formation of cavernous hemangioma.…”

Section: Discussionmentioning

confidence: 99%

“…The lesions usually appear 8–10 years later within brain tissue that was included in radiation fields. [34]…”

Section: Introductionmentioning

confidence: 99%

Metachronous occurrence of nonradiation-induced brain cavernous hemangioma and medulloblastoma in a child with neurofibromatosis type I phenotype

et al. 2012

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Cavernous hemangioma (CH) is a sporadic vascular malformation occurring either as an autosomal dominant condition or as a well-known complication of radiation exposure. Medulloblastoma is a primitive neuroectodermal tumor common in children and currently treated with surgical resection, chemotherapy, and radiotherapy. Neurofibromatosis is the most common single-gene disorder of the central nervous system. Posterior fossa malignant tumors in the context of neurofibromatosis type I (NF1) are very infrequent. This is the first documented case of an unusual metachronous occurrence of non-radiation-induced CH and medulloblastoma in a child with NF1 phenotype. We report the case of a 13-month-old boy with café-au-lait skin lesions associated with NF1-like phenotype who underwent surgical resection of a single CH in the temporal lobe due to recurrent seizures. Four years later he presented with signs of raised intracranial pressure associated with a posterior fossa tumor and hydrocephalus, thus requiring gross total resection of the lesion. Histological analysis revealed a medulloblastoma. After being treated with radiotherapy and chemotherapy, he achieved total remission. Six years later a massive recurrence of the tumor was observed and the child eventually died. The interest in this case lies in the rarity of NF1-like phenotype associated with a non-radiation-induced brain CH and medulloblastoma in a child.

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“…Mutations have also been blamed for cavernoma formation 3 11. Their latency period varies, and their incidence reportedly increases over time 12. Poussaint et al reported a series of 20 pediatric patients with intracranial neoplasia in whom delayed intracranial haemorrhage developed after cranial irradiation or radiation combined with systemic or intrathecal chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Radiation-induced intracranial meningioma and multiple cavernomas

Chourmouzi¹,

Papadopoulou

Kontopoulos

et al. 2013

BMJ Case Reports

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SUMMARYBrain irradiation has several well-known long-term side effects, including radiation-induced neoplasms and vasculopathy. In this case report, we describe an extremely rare case of meningioma and 15 cavernomas developing in a 29-year-old man, 19 years after cranial irradiation for posterior cranial fossa medulloblastoma. To our knowledge, this is the first case of a radiationinduced meningioma accompanied by this many radiation-induced cavernous angiomas. BACKGROUND

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Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma

Abstract: Cavernomas are common after cranial irradiation in children, and their incidence increases over time. Most of these lesions follow a benign course and do not require intervention.

Cited by 51 publications

References 19 publications

Cerebral Abnormalities in Adults with Ataxia-Telangiectasia

Cerebral Abnormalities in Adults with Ataxia-Telangiectasia

Metachronous occurrence of nonradiation-induced brain cavernous hemangioma and medulloblastoma in a child with neurofibromatosis type I phenotype

Radiation-induced intracranial meningioma and multiple cavernomas

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