Radiation induced glioma in a sexagenarian: A case report
You-Heng Peng1, Seidu A Richard1,2, Zhigang Lan1
1Department of Neurosurgery, West China Hospital, Sichuan University; 37 Guo Xue Xiang Road, Chengdu, Sichuan, P. R. China.
Introduction:
Radiation induced gliomas often occurs after radiation therapy for other brain tumors. Medulloblastoma often occurs in children and its associated radiation-induced glioblastoma multiforme's (GBM) after radiotherapy often has a long latency period. Our case is very unique because the medulloblastoma was detected at an advance age and the latency period of radiation-induced GBM was relatively shorter.
Patients Concerns:
A 64-year-old male was first admitted at our hospital in March 2018 with dizziness, vomiting, and blurred vision.
Diagnosis:
Magnetic resonance imaging of brain revealed a lesion with local mixed density and mass enhancement in left cerebellar region. Histopathology established medulloblastoma (World Health Organization) grade 4 and a classic histological subtype after surgery.
Intervention:
Surgical resection followed by radiation therapy were the initial therapeutic modalities.
Outcomes:
In April 2019, the patient was readmitted with dizziness and blurred vision. Magnetic resonance imaging showed the left cerebellar hemisphere bulky enhancement lesion. Again, a multimodal therapy comprising surgical resection, radiation therapy as well as chemotherapy was adapted after histopathology established GBM.
Lesion:
Radiotherapy for medulloblastoma patients at advance ages is a critical predisposing factor for the development of radiation-induced GBM in a very short period of time. We suggest that, radiotherapy as adjuvant therapy for medulloblastoma patients at advance ages should be chosen with extreme caution.
