Second Primary Tumors in Neurofibromatosis 1 Patients Treated for Optic Glioma: Substantial Risks After Radiotherapy

Sharif, Saba; Ferner, Rosalie E.; Birch, Jillian M; Gillespie, James; Gattamaneni, H. R.; Baser, Michael E.; Evans, D. Gareth

doi:10.1200/jco.2005.03.8349

Cited by 333 publications

(173 citation statements)

References 21 publications

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“…This is in contrast to the sporadic PA that are normally formed in the cerebellum [21]. The OPG remain asymptomatic in the majority of patients but can cause visual loss in some patients [22][23][24]. When symptomatic, tumors have been treated with surgery, chemotherapy and radiotherapy.…”

Section: Cns Tumorsmentioning

confidence: 99%

“…When symptomatic, tumors have been treated with surgery, chemotherapy and radiotherapy. The use of radiotherapy is avoided if possible, based on increased risk of developing secondary high grade gliomas [22]. Studies indicate that OPG patients receiving radiotherapy have a three-fold increased risk of developing secondary gliomas, and a nine-fold increased risk of developing an MPNST [22].…”

Section: Cns Tumorsmentioning

confidence: 99%

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Recent developments in brain tumor predisposing syndromes

2015

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Section: Cns Tumorsmentioning

confidence: 99%

Section: Cns Tumorsmentioning

confidence: 99%

Recent developments in brain tumor predisposing syndromes

2015

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“…There is also concern about late vascular events: the incidence of occlusive vasculopathy at the circle of Willis in children with brain tumors is highest among those with OPTs, especially in younger children (29). There is also a heightened concern regarding the risk of second malignancy in patients with NF1 (30). The Toronto group has uniquely reported a 10% incidence of second malignant neoplasms after irradiation for OPTs; of interest, a series from Children's Hospital of Los Angeles showed the same rate of anaplastic degeneration in JPA after surgery alone (31,32).…”

Section: Radiation Therapymentioning

confidence: 94%

“…Gross total resection (GTR) is the treatment of choice for accessible lesions. GTR has been documented in 20-25% of all cases, apparently more often in children and adolescents (30). The OS rate at 10 years after total excision is reported to be about 60% (38).…”

Section: Oligodendrogliomamentioning

confidence: 99%

Malignant Brain Tumors in Childhood

Scarzello

Buzzaccarini

Sotti

2011

Management of CNS Tumors

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“…Unnecessary radiation exposure should be avoided, especially in individuals with nf1, because of the risk of secondary malignancy 24 and other potential complications 25 seen with higher doses of radiation therapy. However, fdg-pet might be useful for the assessment of malignant potential (as in our case 1) and for clinical and surgical planning of unusual presentations (our cases 1 and 2).…”

Section: Figure 1 Case 1 (A) Initial Coronal and Axial Magnetic Resomentioning

confidence: 99%

fdg-pet in Two Cases of Neurofibromatosis Type 1 and Atypical Malignancies

et al. 2014

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A 6-year-old boy was referred for evaluation of a nontender 4-cm left axillary mass, which had recently increased in size. On examination, 6 café-au-lait macules more than 5 mm in diameter were noted, as well as axillary freckling, meeting the clinical diagnostic criteria for nf1.Chest radiography revealed no active disease in the thorax; a complete blood count was normal; and the erythrocyte sedimentation rate was not elevated. Magnetic resonance imaging using multiplanar short T1 inversion recovery sequences revealed a 3×1.6×5-cm mass within the left axilla abutting the chest wall (Figure 1). Imaging characteristics were consistent with benign neurofibroma, mpnst, or lymph node expansion from other malignancy. Because of the tumour's rapid growth, imaging by combined fdg-pet and computed tomography (ct) was obtained to evaluate the lesion's malignant potential. Images revealed a hypermetabolic focus with a maximum standardized uptake value (suv max ) of 5.8 that corresponded with the soft-tissue mass.Because of the increased fdg uptake and recent growth, excisional biopsy was performed. Pathology was consistent with nodular lymphocyte-predominant Hodgkin lymphoma (hl). Imaging of neck, chest, abdomen and pelvis by ct with intravenous contrast showed no other tumours, and the child received no further therapy at that time.He returned 3 months after surgery for surveillance fdg-pet-ct, which revealed no increased fdg uptake in the left axilla, but a new focus of abnormal activity in the left chest wall with an suv max of 5.4, corresponding to a 1.9×1.2-cm soft-tissue mass under the pectoralis major muscle that had not been present during the earlier study. Based on the imaging, a second surgical resection was performed, and histologic evaluation confirmed recurrence of nodular lymphocyte-predominant hl. ABSTRACTPatients with neurofibromatosis type 1 (nf1) are at increased risk for both benign and malignant tumours, and distinguishing the malignant potential of an individual tumour is a common clinical problem in these patients. Here, we review two cases of uncommon malignancies (Hodgkin lymphoma and mediastinal germ-cell tumour) in patients with nf1. Although 18 F-fluorodeoxyglucose positron-emission tomography (fdg-pet) has been used to differentiate benign neurofibromas from malignant peripheral nerve sheath tumours, fdg-pet characteristics for more rare tumours have been poorly described in children with nf1. Here, we report the role of pet imaging in clinical decision-making in each case. In nf1, fdg-pet might be useful in the clinical management of unusual tumour presentations and might help to provide information about the malignant potential of uncommon tumours.

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Second Primary Tumors in Neurofibromatosis 1 Patients Treated for Optic Glioma: Substantial Risks After Radiotherapy

Abstract: There is a significantly increased risk of second nervous system tumors in those NF1 patients who received radiotherapy for their OPGs, especially when treated in childhood. Thus radiotherapy should only be used if absolutely essential in children with NF1.

Cited by 333 publications

References 21 publications

Recent developments in brain tumor predisposing syndromes

Recent developments in brain tumor predisposing syndromes

Malignant Brain Tumors in Childhood

fdg-pet in Two Cases of Neurofibromatosis Type 1 and Atypical Malignancies

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