AB051. Multiple meningiomas developed outside the radiation field after cranial irradiation: a case report
Abstract

AB051. Multiple meningiomas developed outside the radiation field after cranial irradiation: a case report

Seon-Hwan Kim1,2, Kyung Hwan Kim1,2, Eun-Oh Jeong1, Han-Joo Lee1, Hyon-Jo Kwon1, Seung-Won Choi1, Hyeon-Song Koh1

1Department of Neurosurgery, Chungnam National University Hospital, Daejeon, South Korea; 2Cancer Research Institute, Chungnam National University, Daejeon, South Korea

Correspondence to: Seon-Hwan Kim, MD. Department of Neurosurgery, Chungnam National University Hospital, 640 Daesadong, Daejeon, South Korea; Cancer Research Institute, Chungnam National University, Daejeon, South Korea. Email: neons@cnu.ac.kr.

Background: Cranial irradiation has well-known long-term side effects, including radiation-induced neoplasms and vasculopathy. This report describes a case of aggressive and rapid-growing multiple meningiomas developed outside the radiation field after the treatment of medulloblastoma.

Case Description: A 6-year-old boy underwent surgery (gross total resection) and radiotherapy (19.8 Gy for posterior fossa only) against medulloblastoma in the 4th ventricle. The patient could not receive further craniospinal irradiation because of ventriculoperitoneal shunt-related complications. Eighteen years after the radiotherapy, the first meningioma developed in the right temporal convexity, without recurrence of medulloblastoma. It was left untreated because it was asymptomatic. Three years later, the meningioma grew from 0.6 to 6.3 cm3 in volume and another large meningioma (22.1 cm3) developed in the left temporal convexity with additional small meningioma in the right frontal convexity. The left large temporal meningioma showed aggressive nature invading the adjacent temporal bone and temporalis muscle. It was completely resected and the histology revealed as transitional meningioma with 2% of Ki-67. Another new meningioma was identified on the right cerebellar convexity three years post-craniotomy. Subsequent follow-up indicated a progressive increase in the tumor size and gamma knife radiosurgery was performed with right frontal convexity small meningioma. The patient is currently under ongoing surveillance through follow-up assessments.

Conclusions: For patients who received radiotherapy at a young age, clinicians should consider the possibility of secondary neoplasm development even outside the radiation field. Careful imaging follow-up and surgical management are warranted because of the aggressive nature of secondary tumors even though benign in histology.

Keywords: Multiple meningiomas; radiation; medulloblastoma; case report

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab051/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and approved by Chungnam National University Hospital Institutional Review Board (IRB No. 2020-99-027). Written informed consent was obtained from the patient.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this abstract as: Kim SH, Kim KH, Jeong EO, Lee HJ, Kwon HJ, Choi SW, Koh HS. AB051. Multiple meningiomas developed outside the radiation field after cranial irradiation: a case report. Chin Clin Oncol 2024;13(Suppl 1):AB051. doi: 10.21037/cco-24-ab051

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