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Intracranial osteosarcoma after radiosurgery--case report.

Naoko Sanno¹, Shinkichi Hayashi, Toshiro Shimura

¹Department of Neurosurgery, Nippon Medical School, Tamanagayama Hospital, Tokyo, Japan.

Neurologia Medico-Chirurgica

|February 13, 2004

Summary

Osteosarcoma is a rare complication following radiosurgery for brain tumors. This case highlights the potential for developing osteosarcoma years after radiation treatment for benign brain neoplasms.

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Area of Science:

Neuro-oncology
Radiation Oncology
Surgical Pathology

Background:

Radiosurgery is a common treatment for intracranial tumors.
Secondary sarcomatous change after radiotherapy is a rare but documented phenomenon.
Benign brain neoplasms, such as meningioma, are frequently treated with radiosurgery.

Observation:

A 56-year-old woman developed intracranial osteosarcoma at a prior radiosurgery site.
The patient had a history of stereotactic radiosurgery for a falx meningioma.
Clinical presentation included sudden headache, left hemiparesis, and aphasia, with CT revealing hemorrhage.

Findings:

Gross total resection of the osteosarcoma and associated hematoma was achieved.
Histopathological examination confirmed the diagnosis of osteosarcoma.

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The tumor arose at the site of previous stereotactic radiosurgery.

Implications:

This case underscores that osteosarcoma can develop years after radiosurgery for benign brain tumors.
Clinicians should consider secondary sarcomatous change in patients with a history of cranial radiation presenting with new neurological deficits.
Further research into the mechanisms and risk factors for radiation-induced sarcomas is warranted.