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Updated: Jul 9, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Radiation-induced tumor after stereotactic radiosurgery for an arteriovenous malformation: case report
Edwina L Berman1, Thomas N Eade, Daniel Brown
1Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
Objective:
To present a rare case of a radiation-induced malignancy after stereotactic radiosurgery.
Clinical Presentation:
A 34-year-old woman presented with headaches. Imaging studies demonstrated a 4.5-cm arteriovenous malformation located in the pineal region. She was treated with a two-isocenter plan to a total dose of 1500 cGy prescribed to the 70% isodose line. She was lost to follow-up and presented with a change in mental status, nausea, headaches, and a generalized seizure 9 years later. Magnetic resonance imaging scans demonstrated a large, heterogeneously enhancing mass partially in the treatment volume.
Intervention:
Surgical debulking demonstrated an infiltrating glial neoplasm consistent with a glioblastoma multiforme. There was no staining for epidermal growth factor receptor, whereas greater than 75% of nuclei stained positively with p53.
Conclusion:
The risk of radiation-induced tumors is currently unknown but needs to be determined to assess the risk-benefit profile for each patient.
