Pediatric multicentric glioma occurring after cranial irradiation

An 8-year-old girl with no family history of neoplasia underwent biopsy and chemoradiation therapy for a suprasellar mixed germ cell tumor, which resulted in complete remission. A surveillance MRI taken 37 months after irradiation detected a non-enhancing mass in the genu of the corpus callosum. MRI taken 42 months after irradiation revealed significant growth of the mass and a new enhancing lesion in the temporal lobe, which showed rapid growth over 3 weeks. Subtotal resection and biopsy were performed on the lesions in the temporal lobe and the corpus callosum, respectively. Histological examination revealed that the temporal tumor was a glioblastoma multiforme and the frontal lesion was a diffuse astrocytoma. These tumors had newly developed within the irradiated field, but were separated in both location and time. Radiation-induced gliomas may develop within a shorter time interval than previously considered.