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[Radiation induced glioblastoma: a case report]
1Department of Neurosurgery, Yamagata University School of Medicine, Japan.
No to Shinkei = Brain and Nerve
|June 9, 2000
Summary
This case study details a radiation-induced glioblastoma in a patient treated for a pituitary adenoma 20 years prior. The aggressive tumor showed high MIB-1 staining, indicating rapid proliferation.
Area of Science:
- Neuro-oncology
- Radiation oncology
- Neurosurgery
Background:
- A 54-year-old woman developed a radiation-induced glioblastoma 20 years after treatment for a pituitary adenoma.
- The initial treatment involved partial surgical removal and focal irradiation (50 Gy).
Observation:
- The patient presented with aphasia and hemiparesis, indicative of a rapidly growing malignant tumor.
- MRI revealed multiple lesions within the previously irradiated field.
- Magnetic resonance spectroscopy showed increased lactate and decreased N-acetyl aspartate, choline, creatine, and phosphocreatine.
Findings:
- Histological examination confirmed glioblastoma with radiation necrosis and a high MIB-1 staining index (65%).
- The tumor exhibited continuity across multiple brain regions, including the temporal lobes and brainstem.
- The high MIB-1 index suggests a greater proliferative potential compared to de novo or secondary glioblastomas.
Implications:
- Radiation-induced glioblastoma is a rare but aggressive complication of radiotherapy.
- Early detection and understanding the high proliferative potential are crucial for managing these tumors.
- This case highlights the long-term risks associated with cranial irradiation.