Well differentiated astrocytoma occurring nine years after radiation therapy for medulloblastoma

Conventional treatment for medulloblastoma includes surgical resection followed by craniospinal irradiation, with the potential risk of subsequent radiotherapy-induced secondary neoplasms. We report a 23-year-old woman previously irradiated nine years earlier for a cerebellar medulloblastoma who developed a new enhancing lesion in the primary radiation field four weeks following completion of high dose chemotherapy with bone marrow transplantation for recurrent disease. Resection of this lesion revealed a low grade glioma with no evidence of recurrent medulloblastoma.