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Thorotrast-induced primary cerebral angiosarcoma: case report.

Gopalakrishnan Balamurali¹, Daniel G du Plessis, Moses Wengoy

¹Department of Neurosurgery, Salford Royal Hospitals, Manchester, England. drbala73@hotmail.com

|July 4, 2009

Summary

This case report details a rare primary intracerebral angiosarcoma in a patient with prior Thorotrast exposure. The findings suggest Thorotrast may induce brain tumors, highlighting long-term risks of this historical contrast agent.

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Area of Science:

Neuropathology
Radiology
Oncology

Background:

Thorotrast, a radioactive contrast agent used until the 1960s, has been linked to various cancers, primarily in the liver.
While Thorotrast-associated angiosarcomas are known, primary brain tumors are exceptionally rare.
This study focuses on a unique case of a primary intracerebral angiosarcoma following Thorotrast exposure.

Observation:

A 68-year-old male presented with neurological deficits 62 years after receiving Thorotrast for a cerebral abscess.
Imaging revealed a right parietal tumor.
Surgical exploration identified a highly vascular, infiltrating tumor associated with a Thorotrast granuloma.

Findings:

Histopathological analysis confirmed a well-differentiated angiosarcoma.

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Radioactivity consistent with Thorotrast was detected within the tumor.

The long latency period and tumor characteristics strongly suggest Thorotrast as the causative agent.

Implications:

This case may represent the first documented instance of a primary intracerebral angiosarcoma induced by Thorotrast.
It underscores the potential for delayed central nervous system malignancies following historical Thorotrast use.
Highlights the importance of considering long-term sequelae of radioactive contrast agents in neuro-oncology.