Katja[a]
Radiation-induced tumor after stereotactic radiosurgery and whole brain radiotherapy: case report and literature review.
J Neurooncol. 2004 Feb;66(3):301-5.
McIver JI, Pollock BE.
Department of Neurological Surgery, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Radiation-induced neoplasms are extremely rare after stereotactic radiosurgery. To date, only 3 cases meet Cahan´s criteria in the world literature. We present a fourth case of a radiation-induced neoplasm arising after radiosurgery. The patient is a 43-year-old woman who presented with a right cerebellar anaplastic astrocytoma 64 months after radiosurgery for metastatic melanoma. Initially, 3 brain metastases involving the inferior right temporal (2 tumors) and right frontal regions were treated. Following radiosurgery, the patient underwent whole brain radiotherapy (37.5 Gy). Twenty-two months later, a second radiosurgical procedure was performed for a recurrent right temporal lobe metastasis. The area of cerebellum where the glioma developed received a maximum dose of 7.7 and 1.5 Gy during the 2 procedures, respectively. Support that radiosurgery contributed to the development of this glioma are the tumor´s location and the rarity of adult cerebellar astrocytomas. The risk of radiation-induced tumors after radiosurgery is unknown. To better define the incidence of radiation-induced neoplasms after radiosurgery, all potential cases should be presented and discussed in an open, candid fashion.