Radiation-induced meningiomas: experience at the Mount Sinai Hospital and review of the literature

Harrison, Michael J.; Wolfe, David; Lau, Thomas K.H.; Mitnick, Robin J.; Sachdev, Ved P.

doi:10.3171/jns.1991.75.4.0564

Cited by 192 publications

(164 citation statements)

References 76 publications

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“…Neurological tissue was long considered relatively resistant to damage from x-rays, 16,24,45 and some authors suggested that higher doses allowed longer survival in patients with glioblastoma multiforme. 6,61 In 1938, Davidoff et al 13 described the clinical and histological effects of delivering 10-50 Gy in a single exposure, or 48-72 Gy in 2 fractions, applied directly to the brains and spinal cords in monkeys.…”

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confidence: 99%

Radiation-induced meningioma

Umansky¹,

Shoshan²,

Rosenthal³

et al. 2008

FOC

181

148

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✓ The long-term or delayed side effects of irradiation on neural tissue are now known to include the induction of new central nervous system neoplasms. However, during the first half of the 20th century, human neural tissue was generally considered relatively resistant to the carcinogenic and other ill effects of ionizing radiation. As a result, exposure to relatively high doses of x-rays from diagnostic examinations and therapeutic treatment was common. In the present article the authors review the literature relating to radiation-induced meningiomas (RIMs). Emphasis is placed on meningiomas resulting from childhood treatment for primary brain tumor or tinea capitis, exposure to dental x-rays, and exposure to atomic explosions in Hiroshima and Nagasaki. The incidence and natural history of RIMs following exposure to high- and low-dose radiation is presented, including latency, multiplicity, histopathological features, and recurrence rates. The authors review the typical presentation of patients with RIMs and discuss unique aspects of the surgical management of these tumors compared with sporadic meningioma, based on their clinical experience in treating these lesions.

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confidence: 99%

Radiation-induced meningioma

Umansky¹,

Shoshan²,

Rosenthal³

et al. 2008

FOC

181

148

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“…Although several studies support the role of previous radiation exposure in the development of brain tumors, most of them do not specifically mention PAs. 10,[15][16][17][18][19][20][21] This also holds true for the Israeli Tinea Capitis Study, in which comparisons between the rate of tumors in the irradiated group and the nonirradiated control group showed a significant excess risk for various tumors arising in the irradiated area, including benign and malignant brain tumors. 20 However, to date, an excessive risk for PA has not been indicated.…”

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confidence: 99%

A possible association between ionizing radiation and pituitary adenoma

Juven

Sadetzki

2002

Cancer

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BACKGROUNDDespite the recognition of ionizing radiation as a causal risk factor for a variety of solid tumors (including brain tumors), to date, such an association with pituitary adenoma (PA) has not been demonstrated.METHODSTo evaluate a possible association between past exposure to radiation and the occurrence of PA, the authors reviewed about 4900 medical records of patients who had been irradiated in childhood for tinea capitis. An additional search for patients was performed using the Israel Cancer Registry. The average radiation dose to the pituitary gland was estimated as 0.56 grays, and, for all patients, a meticulous validation of the irradiation was performed.RESULTSA group of 16 patients who developed symptomatic PA after childhood exposure to radiotherapy were identified. Overall, the clinical and demographic characteristics of these patients were similar to other series reported in the literature. There was an apparently high rate of second primary tumors (25%), all of them in the irradiated area, diagnosed among this group. The methodologic issues that limit the demonstration of a possible association between radiation and PA and the epidemiologic and experimental findings in the literature are discussed.CONCLUSIONSIn view of the ample amount of evidence identifying low‐dose ionizing radiation as a risk factor for a number of intracranial tumors as well as for tumors arising in endocrine organs, a radiation immunity of the pituitary gland is difficult to accept. Hence, the authors suggest that this series should be considered as preliminary observation that supports the role of ionizing radiation in the development of this tumor. Cancer 2002;95:397–403. © 2002 American Cancer Society.DOI 10.1002/cncr.10667

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“…These tumors may also have been induced by the radiotherapy as they have been described in other diseases treated by radiotherapy. 5,6 In fact, one of these patients received brain irradiation before allogeneic BMT and both received total body irradiation as part of their conditioning regimen. It is, however, clear that the role of radiotherapy in the genesis of these tumors can only be properly assessed by long-term follow-up trials comparing patients randomly assigned to be given CNS radiotherapy or no radiation.…”

Section: Discussionmentioning

confidence: 99%

Meningioma in long-term survivors after allogeneic bone marrow transplantation

Meignin

Gluckman

Gambaraelli

et al. 1998

Bone Marrow Transplant

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Summary:Late complications occurring after allogeneic bone marrow transplant (BMT) are increasingly reported, since more patients survive. Among these late complications, solid tumors are of particular clinical concern. Only malignant brain tumors have been reported (astrocytoma, glioblastoma). We describe two cases of meningiomas developing 13 and 15 years after the graft. Occurrence of such benign tumors has been described after treatment of ALL, but not following allogeneic BMT. It is important to consider the diagnosis of meningioma in long-term survivors presenting with neurological symptoms. Keywords: ALL; AML; ABMT meningioma Among the late effects that have been described after allogeneic BMT, solid tumors are of particular concern as an increasing number of patients survive the early phase after transplantation and remain free of their original disease. 1 Among solid tumors, several cases of malignant brain tumors have been described but no benign tumors. [2][3][4] We report here two cases of cranial meningiomas developing 13 and 15 years after allogeneic BMT for AML and ALL. Case reports Case 1In 1982, a 24-year-old patient with AML was in first complete remission after treatment with cytarabine, rubidomycin, doxorubicin and thioguanine as induction therapy, followed by 3 weekly courses of cytarabine and thioguanine. He then underwent BMT from an HLA-identical sibling donor. Conditioning comprised cyclophosphamide (60-mg/kg J1-2) and total body irradiation (10 Gy, in a single fraction). He remained well until 1995, when he experi- enced two episodes of temporal lobe epilepsy. A CT scan showed a left frontotemporal tumor and a diagnosis of meningioma was made by stereotactic biopsy. Histological studies confirmed the diagnosis of meningotheliomatous meningioma but showed necrosis and many atypical features. There were many cytogenetic abnormalities (monosomy 22, 10, 15, trisomy 5, del (11q14), del (2p12), 1qh+). The patient is now well on antiepileptic treatment. Case 2In 1980, a 17-month-old patient was diagnosed with standard risk B cell ALL. As part of the ongoing protocol (12 LA 80), he received total brain irradiation of 24 Gy as central nervous system (CNS) prophylaxis. Treatment was discontinued in 1984, while the patient was in complete remission. He presented with a medullary and testicular relapse 1 year later and was treated with chemotherapy again (RALL 84 protocol) and testicular irradiation (10 Gy in a single fraction). He then underwent allogeneic BMT from an HLA-identical sibling donor while in second complete remission. Conditioning comprised chemotherapy (VP 16, cytarabine and cyclophosphamide) and total body irradiation (10 Gy, in a single dose). In 1995, a CT scan was performed because of left exopthalmus and oculomotor paralysis (third cranial nerve). It showed an intraocular and intracavernous lesion associated with many hypodensities in the brain. A diagnosis of meningotheliomatous meningioma was made on biopsy. As the tumor increased rapidly in size, it was surgically removed, al...

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Radiation-induced meningiomas: experience at the Mount Sinai Hospital and review of the literature

Cited by 192 publications

References 76 publications

Radiation-induced meningioma

Radiation-induced meningioma

A possible association between ionizing radiation and pituitary adenoma

Meningioma in long-term survivors after allogeneic bone marrow transplantation

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