Brain tumors among electronics industry workers

We evaluated the relation between work experience in the United States operations of an electronics company and brain tumor mortality, focusing on video display terminal (VDT) development jobs. Subjects were 149 brain tumor cases and 591 matched controls selected from a company registry of all employees dying between 1975 and 1989. Company databases and interviews with company personnel constituted the basis for work histories, including information on whether subjects had held VDT development jobs. Subjects who worked at plants with hardware or VDT development operations had slightly but imprecisely elevated odds ratios (OR). The study found no meaningful association between VDT development work and brain tumor mortality. Other results included an elevated OR for 10 or more years of employment in engineering/technical jobs [OR = 1.7; 95% confidence interval (CI) = 1.0-3.0] or in programming jobs (OR = 2.8; 95% CI = 1.1-7.0). The OR for glioma for all subjects who had accrued 5 years of programming work 10 years before the case's death was 3.9 (95% CI = 1.2-12.4). These associations were limited in large part to one of four division groups. Also, only male programmers experienced an elevated OR. These patterns indicate that the associations may be due to chance, although unidentified causal exposures present in a subset of engineering/technical and programming jobs cannot be ruled out.

Cerebral glial tumors and human immunodeficiency virus-1 infection. More than a coincidental association

BACKGROUND

The authors describe the clinical and morphologic patterns in four patients with acquired immune deficiency syndrome (AIDS) who developed intracranial glial tumors.

METHODS

This retrospective study reports 70 patients at various stages of human immunodeficiency virus-1 (HIV-1) infection who underwent stereotactic brain biopsy for an intracerebral space-occupying lesion.

RESULTS

Of these patients, four had glial tumors: one astroblastoma, two astrocytomas, and one glioblastoma. Glial tumors probably arise from a complex interplay of factors; possibilities include the activation of a dominant oncogene or viral inactivation of a tumor suppressor gene by a viral promoter (like the tat protein), impairment of immune defenses (which facilitates the growth of astrocytomas in acute lymphoblastic leukemia), production of cellular growth factors, cytokines, possible infection of glial cells by HIV, and the potentiation of a coinfectious agent.

CONCLUSIONS

These cases illustrate that glial tumors should be considered in the differential diagnosis of brain masses in HIV-1 infection, especially because specific treatment for these tumors is available. Moreover, the occurrence of glial tumors in AIDS patients is not only an important event from a clinical point of view, but may also have implications for the pathogenesis of tumors in AIDS.

[A case of paraventricular anaplastic astrocytoma following radiation therapy for craniopharyngioma]

A 20-year-old man received 60 Gy of radiation therapy after partial removal of craniopharyngioma. The patient had been well and follow-up CT scans did not show any aggravation for 16 years. Since his activity gradually diminished, he underwent an MRI at the age of 36 which revealed an abnormal mass on the corpus callosum. The mass lesion progressively enlarged thereafter, and was diagnosed as anaplastic astrocytoma by a stereotactic biopsy. He was treated with interferon, however, died at the age of 37. Review of literature disclosed 19 other cases of glioma following radiation therapy for sellar/parasellar tumors. Characteristic features of these cases included 1) lowness of age compared to common glioma cases, 2) tendency to be malignant, 3) tendency to occur in areas where significant doses of radiation had been received previously.

Glioblastoma multiforme of donor origin after renal transplantation: report of a case

A case of transmission of a glioblastoma multiforme from the donor to a kidney transplant recipient in the absence of previous ventriculosystemic shunt is described. The recipient was a 48-year-old woman who developed a fever with no other associated symptoms 17 months posttransplant. Physical examination revealed a large nonpulsatile mass on the upper graft pole. Histopathologic examination showed a highly cellular neoplasm with fusiform and globoid cells, a high grade of nuclear pleomorphism and mitosis, necrosis with pseudopalisading, and vascular proliferation. Immunohistochemistry of the cells showed them to contain glial fibrillary acidic and S-100 proteins, consistent with a glioblastoma multiforme. We conclude that the risk of tumor transmission from donors with primary central nervous system tumors to kidney transplant recipients, is real and should be considered when evaluating a graft mass in such patients.

Malignant astrocytoma of the optic nerve in a child

Malignant gliomas of optic nerve and chiasm are rare, rapidly fatal neoplasms of adulthood. This report documents the occurrence of a malignant astrocytoma of the optic nerve in an 11-year-old boy who 9 years previously had a cerebellar medulloblastoma treated with surgery and irradiation. This malignant optic nerve glioma followed the same aggressive clinical course as that seen in adults, with death 9 months after diagnosis despite surgery and chemotherapy. Radiation may have been an important factor in the development of this malignant tumor which is almost never seen in the pediatric age group.

Prevalence of glioblastoma multiforme in subjects with prior therapeutic radiation

This retrospective study profiled subjects with glioblastoma multiforme (GBM) who had previously received therapeutic radiation. A chart review was conducted of 100 adult patients diagnosed with GBM and referred to a major medical center in the southwestern United States. Seventeen patients received previous radiation therapy with an average dose of 48.5 Grey (Gy) and an average latency period of 15 years between initial therapy and GBM diagnosis. Of these 17, four white females fit all four attribution criteria for radiation-induced GBM. Two had been treated with radiation for prolactinomas, one for pinealoma and one for squamous cell cancer of the ethmoid sinus. The addition of these four case studies to the previously published descriptions of 80 cases of gliomas, 36 of which were GBM, subsequent to radiation therapy provides additional support for considering therapeutic radiation as a risk factor for GBM development.

Radiation-induced cerebellar glioblastoma multiforme subsequent to treatment of an astrocytoma of the cervical spinal cord

A cerebellar glioblastoma multiforme was diagnosed in a 22-year-old woman. This originated in the zone adjacent to a field irradiated 14 years earlier after the removal of a noncontiguous astrocytoma of the spinal cord. The accepted criteria for radiation-induced tumors of the central nervous system are discussed.

A report on radiation-induced gliomas

Radiation-induced gliomas are uncommon, with only 73 cases on record to date. The disease that most frequently occasioned radiation therapy has been acute lymphoblastic leukemia (ALL). Three more cases are added here, two after irradiation for ALL and one after irradiation for tinea capitis. In a review of the relevant literature, the authors stress the possibility that the ALL-glioma and the retinoblastoma-glioma links point to syndromes in their own right that may occur without radiation therapy.

[Tumors of the central nervous system induced by ionizing radiation. Update on their pathology and presentation of a case]

Ionizing radiation-induced neoplasias are frequently described in literature but only 100 case about interested the central nervous system. The authors add a possible personal observation and line the main features of this association.

Radiotherapy of nonfunctional adenomas of the pituitary gland. Results with long-term follow-up

A total of 112 patients with the diagnosis of nonfunctional pituitary adenoma received radiation therapy at the University of Pittsburgh between 1964 and 1987. Postoperative radiation therapy was administered in 87 patients. Actuarial progression-free survival (tumor control) at 5, 10, 15, and 20 years was 97%, 89%, 87%, and 76%, respectively. Radiation prescribed to the 95% isodose ranged from 35.72 Gy to 62.32 Gy. Multivariate analysis showed decreased tumor control to be significantly associated with increasing field size (P = .036). No improvement in tumor control could be detected with increasing total radiation dose or nominal standard dose (NSD). One patient developed optic neuropathy and another developed a glioblastoma after doses in both patients of 4750 cGy in 25 fractions. External beam radiotherapy for nonfunctional pituitary adenomas was found to be effective and safe when doses less than 4750 cGy in 25 fractions were used.

Postradiation astrocytoma. Report of two cases

The authors describe two cases of malignant astrocytomas associated with previous radiation therapy in childhood for intracranial germinoma and craniopharyngioma. In both patients, there was no recurrence at the primary tumor site. Because of a geometric coincidence between the tumor location and the radiation field, radiotherapy was strongly implicated as a cause of these two astrocytomas.

Occupational factors associated with astrocytomas: a case-control study

The most malignant form of all brain tumors is the supratentorial astrocytoma. Little is known about its etiology, but exogenous factors have been blamed. In this case-control study, 78 astrocytoma patients have been compared with 197 clinical and 92 population controls. An extensive questionnaire was used to gather information about occupational and residential environment exposure. Inquiries concerning groups of or individual chemicals elicited low rates of affirmative response, with negligible differences between cases and controls. However, the questions "working at an airfield" and "living near a petrochemical plant" indicated elevated risks in comparison with both control groups; so too did "living near a municipal sewage treatment plant." These results focus attention on exposure to organic compounds and should be considered together with similar findings in current research. No other occupation, branch of industry, or vicinity questions showed differences between cases and controls, with the exception of "living in the neighborhood of a paper mill or a saw mill," which gave moderately increased relative risks. A separate report gives the results from the nonoccupational part of the study.

Serial neuropsychological studies of a child with acute lymphoblastic leukemia and subsequent glioblastoma multiforme

A 10-year-old boy had a right posterior parietal glioblastoma 5 years after completing treatment for acute lymphoblastic leukemia. Interim findings included seizures, leukoencephalopathy, diffuse mineralizing microangiopathy, and abnormal changes in neuropsychological test performance, which, in retrospect, provided information about the location of the tumor. This case highlights unusual sequelae of childhood leukemia and its treatment, as well as the value of neuropsychological procedures in assessing functional status and integrity of the brain.

Glioblastoma occurring after radiation therapy for meningioma: case report and review of literature

A 32-year-old man developed an intracranial glioblastoma multiforme 10 years after irradiation for an incompletely resected convexity meningioma. The association of these two tumors is exceedingly rare. Therefore, we propose that this is a case of radiation-induced glioma and review the evidence supporting this view.

Occurrence of brain tumors in rhesus monkeys exposed to 55-MeV protons

Twenty-year observation of monkeys exposed to single doses of high energy protons simulating solar particles revealed that the most prevalent fatal cancers were brain tumors in the group of animals exposed to 55-MeV protons. Of 72 animals (50 males and 22 females) receiving 0.25 to 8.0 Gy total body surface dose, nine developed fatal tumors classified as grade IV astrocytoma or glioblastoma multiforme. The latent period for tumor development ranged from 14 months to 20 years, with a median of 5 years. Doses associated with the tumors were 4.0 to 8.0 Gy. Eight males and one female were affected. Depth-dose determinations suggest that the high incidence of cerebral neoplasia is associated with the Bragg Peak energy distribution of the 55-MeV protons. Comparison of the tumor incidence with that in humans with brain exposures incidental to radiotherapy indicates a high biological effectiveness compared with gamma radiation. Studies are in progress to attempt to replicate the results in rodents and establish a dose-response curve for proton-induced brain tumors.

Malignant glioma after bombshell injury

A case of post-traumatic glioma is presented. The patient, wounded in the head in World War II by a bombshell, developed symptoms of an intracranial tumor in 1982. Histopathologically the tumor was an astrocytoma grade III. The tumor was in direct continuity with an old abscess membrane.

Glioblastoma multiforme after radiotherapy for acromegaly

A case of glioblastoma multiforme that occurred 14 years after radiotherapy for acromegaly is presented. The striking correspondence between the anatomy of the tumor and the geometry of the radiation ports is suggestive of a causal relationship. Previously reported cases of radiation-associated glioma are reviewed, and a brief appraisal of the evidence for induction of these lesions by radiation is presented. The differentiation of radiation-associated neoplasms from radionecrosis is also discussed.