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Ravnik J, Rowbottom H. The Impact of Molecular and Genetic Analysis on the Treatment of Patients with Atypical Meningiomas. Diagnostics (Basel) 2024; 14:1782. [PMID: 39202270 PMCID: PMC11353905 DOI: 10.3390/diagnostics14161782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/04/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024] Open
Abstract
Meningiomas represent approximately 40% of all primary tumors of the central nervous system (CNS) and, based on the latest World Health Organization (WHO) guidelines, are classified into three grades and fifteen subtypes. The optimal treatment comprises gross total tumor resection. The WHO grade and the extent of tumor resection assessed by the Simpson grading system are the most important predictors of recurrence. Atypical meningiomas, a grade 2 meningioma, which represent almost a fifth of all meningiomas, have a recurrence rate of around 50%. Currently, different histopathologic, cytogenetic, and molecular genetic alterations have been associated with different meningioma phenotypes; however, the data are insufficient to enable the development of specific treatment plans. The optimal treatment, in terms of adjuvant radiotherapy and postoperative systemic therapy in atypical meningiomas, remains controversial, with inconclusive evidence in the literature and existing studies. We review the recent literature to identify studies investigating relevant atypical meningioma biomarkers and their clinical application and effects on treatment options.
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Affiliation(s)
- Janez Ravnik
- Department of Neurosurgery, University Medical Centre Maribor, 2000 Maribor, Slovenia;
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Hsieh AL, Bi WL, Ramesh V, Brastianos PK, Plotkin SR. Evolving concepts in meningioma management in the era of genomics. Cancer 2024; 130:2586-2600. [PMID: 38753473 PMCID: PMC11260245 DOI: 10.1002/cncr.35279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 05/18/2024]
Abstract
Meningioma is the most common type of primary brain tumor. Surgical resection followed by surveillance is the first-line treatment for the majority of symptomatic meningiomas; however, recent advances in molecular sequencing, DNA methylation, proteomics, and single-cell sequencing provide insights into further characterizing this heterogeneous group of tumors with a wide range of prognoses. A subset of these tumors are highly aggressive and cause severe morbidity and mortality. Therefore, identifying those individuals with a poor prognosis and intervening are critical. This review aims to help readers interpret the molecular profiling of meningiomas to identify patients with worse prognoses and guide the management and strategy for surveillance.
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Affiliation(s)
- Annie L. Hsieh
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wenya Linda Bi
- Department of Neurosurgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Vijaya Ramesh
- Department of Neurology and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Priscilla K Brastianos
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Central Nervous System Metastasis Program, Massachusetts General Hospital, Boston, MA, United States
- Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Scott R. Plotkin
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Li J, Zhang X, Liu J, Su C, Cui J, Yang L, Gu Y. Case report: Low-dose radiation-induced meningioma with a short latency period. Front Oncol 2024; 14:1413610. [PMID: 39011474 PMCID: PMC11246846 DOI: 10.3389/fonc.2024.1413610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024] Open
Abstract
Patients with radiation-induced meningioma (RIM), most of whom had received head radiation therapy or had been exposed to ionizing radiation during childhood or adolescence, are at risk of developing cranial meningiomas throughout their lifetimes because of the long latency period. Although intermediate-to-high-dose ionizing radiation exposure is an established risk factor for RIM, risk factors for low-dose RIM remain incompletely defined. This study presents the case of a 56-year-old woman diagnosed with radiation-induced giant meningioma 2.5 years after undergoing an interventional embolization procedure for a brain aneurysm. This is the first report of RIM attributable to a brain intervention with an extremely short latency period. The total radiation dose received by the patient during the operation was 1367.3 mGy, representing a low dose. Our case report strengthens the evidence that even low radiation doses can increase the risk of RIM. These findings provide a realistic basis for the theoretical study of RIM and suggest some new ideas for RIM treatment. The need for caution in the use of radioactive treatments and optimization of interventional procedures is highlighted.
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Affiliation(s)
- Jinyang Li
- School of Clinical Medicine, Shandong Second Medical University, Weifang, China
| | - Xiangmao Zhang
- Department of Neurosurgery, Zibo Central Hospital, Zibo, China
| | - Jing Liu
- Department of Pharmacy Intravenous Admixture Service, Zibo Central Hospital, Zibo, China
| | - Chunxia Su
- Department of Admissions Service Center, Zibo Central Hospital, Zibo, China
| | - Junxiang Cui
- School of Clinical Medicine, Shandong Second Medical University, Weifang, China
| | - Liling Yang
- School of Clinical Medicine, Shandong Second Medical University, Weifang, China
| | - Yinghao Gu
- Department of Neurosurgery, Zibo Central Hospital, Zibo, China
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Yarabarla V, Mylarapu A, Han TJ, McGovern SL, Raza SM, Beckham TH. Intracranial meningiomas: an update of the 2021 World Health Organization classifications and review of management with a focus on radiation therapy. Front Oncol 2023; 13:1137849. [PMID: 37675219 PMCID: PMC10477988 DOI: 10.3389/fonc.2023.1137849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 07/19/2023] [Indexed: 09/08/2023] Open
Abstract
Meningiomas account for approximately one third of all primary intracranial tumors. Arising from the cells of the arachnoid mater, these neoplasms are found along meningeal surfaces within the calvarium and spinal canal. Many are discovered incidentally, and most are idiopathic, although risk factors associated with meningioma development include age, sex, prior radiation exposure, and familial genetic diseases. The World Health Organization grading system is based on histologic criteria, and are as follows: grade 1 meningiomas, a benign subtype; grade 2 meningiomas, which are of intermediately aggressive behavior and usually manifest histologic atypia; and grade 3, which demonstrate aggressive malignant behavior. Management is heavily dependent on tumor location, grade, and symptomatology. While many imaging-defined low grade appearing meningiomas are suitable for observation with serial imaging, others require aggressive management with surgery and adjuvant radiotherapy. For patients needing intervention, surgery is the optimal definitive approach with adjuvant radiation therapy guided by extent of resection, tumor grade, and location in addition to patient specific factors such as life expectancy. For grade 1 lesions, radiation can also be used as a monotherapy in the form of stereotactic radiosurgery or standard fractionated radiation therapy depending on tumor size, anatomic location, and proximity to dose-limiting organs at risk. Optimal management is paramount because of the generally long life-expectancy of patients with meningioma and the morbidity that can arise from tumor growth and recurrence as well as therapy itself.
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Affiliation(s)
- Varun Yarabarla
- Philadelphia College of Osteopathic Medicine, Suwanee, GA, United States
| | - Amrutha Mylarapu
- Department of Internal Medicine, Advent Health Redmond, Rome, GA, United States
| | - Tatiana J. Han
- Department of Internal Medicine, WellSpan Health, York, PA, United States
| | - Susan L. McGovern
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Shaan M. Raza
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Thomas H. Beckham
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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DNA methylation provides diagnostic value for meningioma recurrence in clinical practice. Acta Neurochir (Wien) 2023; 165:1323-1331. [PMID: 36920663 DOI: 10.1007/s00701-023-05550-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/14/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Meningiomas are the most common intracranial tumors. Recent advancements in the genetic profiling of tumors have allowed information including DNA copy number analysis, mutational analysis, and RNA sequencing to be more frequently reported, in turn allowing better characterization of meningiomas. In recent years, analysis of tumor methylomes that reflects both cell-origin methylation signatures and somatically acquired DNA methylation changes has been utilized to better classify meningiomas with great success. METHOD We report DNA methylation profiling on meningiomas from 17 patients. Formalin-fixed paraffin-embedded (FFPE) meningioma tumor samples were processed, loaded onto the Infinium Methylation EPIC array, and scanned using the Illumina IScan system. Raw IDAT files were processed through the the CNS tumor classifier developed by the Molecular Neuropathology group at the German Cancer Research Center (DKFZ). Corresponding genomics were captured using targeted sequencing panels. RESULT Among the meningioma samples, 13 samples were classified as "benign," two samples as "intermediate," and the remaining three samples (from two patients) as "malignant," based on previously validated classification algorithms. In addition to tumor methylation profiling, we also present information that includes patient demographics, clinical presentations, tumor characteristics (including size and location), surgical approaches, and mutational analysis. The two patients who provided the samples with "malignant" methylation classifications had tumor recurrence, reflecting a more aggressive disease course. CONCLUSION In accordance with prior reports, our case series provides support that tumor DNA methylation profiling adds meaningful classification information and may be beneficial to incorporate in clinical practice. Our report also reveals that DNA methylation combined with WHO histology classification can more accurately predict tumor behavior than WHO classification alone.
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Maeda Y, Onishi S, Yamasaki F, Takayasu T, Yonezawa U, Taguchi A, Horie N. Secondary meningioma after cranial irradiation: case series and comprehensive literature review. Jpn J Clin Oncol 2023; 53:212-220. [PMID: 36524362 DOI: 10.1093/jjco/hyac191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Secondary meningioma after cranial irradiation, so-called radiation-induced meningioma, is one of the important late effects after cranial radiation therapy. In this report, we analyzed our case series of secondary meningioma after cranial irradiation and conducted a critical review of literature to reveal the characteristics of secondary meningioma. MATERIALS AND METHODS We performed a comprehensive literature review by using Pubmed, MEDLINE and Google scholar databases and investigated pathologically confirmed individual cases. In our institute, we found pathologically diagnosed seven cases with secondary meningioma between 2000 and 2018. Totally, 364 cases were analyzed based on gender, WHO grade, radiation dose, chemotherapy. The latency years from irradiation to development of secondary meningioma were analyzed with Kaplan-Meier analysis. Spearman's correlation test was used to determine the relationship between age at irradiation and the latency years. RESULTS The mean age at secondary meningioma development was 35.6 ± 15.7 years and the mean latency periods were 22.6 ± 12.1 years. The latency periods from irradiation to the development of secondary meningioma are significantly shorter in higher WHO grade group (P = 0.0026, generalized Wilcoxon test), higher radiation dose group (P < 0.0001) and concomitant systemic chemotherapy group (P = 0.0003). Age at irradiation was negatively associated with the latency periods (r = -0.23231, P < 0.0001, Spearman's correlation test). CONCLUSION Cranial irradiation at older ages, at higher doses and concomitant chemotherapy was associated with a shorter latency period to develop secondary meningiomas. However, even low-dose irradiation can cause secondary meningiomas after a long latency period. Long-term follow-up is necessary to minimize the morbidity and mortality caused by secondary meningioma after cranial irradiation.
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Affiliation(s)
- Yugo Maeda
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Neurosurgery, Miyoshi Municipal Central Hospital, Hiroshima, Japan
| | - Shumpei Onishi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Takayasu
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ushio Yonezawa
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akira Taguchi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Wang EJ, Haddad AF, Young JS, Morshed RA, Wu JPH, Salha DM, Butowski N, Aghi MK. Recent advances in the molecular prognostication of meningiomas. Front Oncol 2023; 12:910199. [PMID: 36686824 PMCID: PMC9845914 DOI: 10.3389/fonc.2022.910199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/17/2022] [Indexed: 01/05/2023] Open
Abstract
Meningiomas are the most common primary intracranial neoplasm. While traditionally viewed as benign, meningiomas are associated with significant patient morbidity, and certain meningioma subgroups display more aggressive and malignant behavior with higher rates of recurrence. Historically, the risk stratification of meningioma recurrence has been primarily associated with the World Health Organization histopathological grade and surgical extent of resection. However, a growing body of literature has highlighted the value of utilizing molecular characteristics to assess meningioma aggressiveness and recurrence risk. In this review, we discuss preclinical and clinical evidence surrounding the use of molecular classification schemes for meningioma prognostication. We also highlight how molecular data may inform meningioma treatment strategies and future directions.
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Affiliation(s)
- Elaina J. Wang
- Department of Neurological Surgery, Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Alexander F. Haddad
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Jacob S. Young
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Ramin A. Morshed
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Joshua P. H. Wu
- Department of Neurological Surgery, Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Diana M. Salha
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Nicholas Butowski
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Manish K. Aghi
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States,*Correspondence: Manish K. Aghi,
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Wang JZ, Agnihotri S, Zadeh G. Radiation-Induced Meningiomas. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1416:159-173. [PMID: 37432626 DOI: 10.1007/978-3-031-29750-2_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
While the majority of meningiomas encountered clinically are sporadic, there is a rare subset that arises due to early life or childhood irradiation. Sources of this radiation exposure may be due to treatment of other cancers such as acute childhood leukemia, other central nervous system tumors such as medulloblastoma, the treatment of tinea capitis (rarely and historically), or environmental exposures, as seen in some of the Hiroshima and Nagasaki atomic bomb survivors. Regardless of their etiology, however, radiation-induced meningiomas (RIMs) tend to be highly biologically aggressive irrespective of WHO grade and are usually refractory to the conventional treatment modalities of surgery and/or radiotherapy. In this chapter, we will discuss these RIMs in their historical context, their clinical presentation, their genomic features and ongoing efforts to better understand these tumors from a biological standpoint in order to develop better, more efficacious therapies for these patients.
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Affiliation(s)
- Justin Z Wang
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada.
- Division of Neurosurgery, Department of Surgery, The University of Toronto, Toronto, ON, Canada.
| | - Sameer Agnihotri
- University of Pittsburgh Hillman Cancer Center, Pittsburgh, PA, USA
| | - Gelareh Zadeh
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada
- Division of Neurosurgery, Department of Surgery, The University of Toronto, Toronto, ON, Canada
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Molecular classification and grading of meningioma. J Neurooncol 2023; 161:373-381. [PMID: 36802047 DOI: 10.1007/s11060-022-04228-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/21/2022] [Indexed: 02/21/2023]
Abstract
PURPOSE Meningiomas are the most common primary intracranial tumor in older adults (Ostrom et al. in Neuro Oncol 21(Suppl 5):v1-v100, 2019). Treatment is largely driven by, in addition to patient characteristics and extent of resection/Simpson grade, the World Health Organization (WHO) grading of meningiomas. The current grading scheme, based predominantly on histologic features and only limited molecular characterization of these tumors (WHO Classification of Tumours Editorial Board, in: Central nervous system tumours, International Agency for Research on Cancer, Lyon, 2021), (Mirian et al. in J Neurol Neurosurg Psychiatry 91(4):379-387, 2020), does not consistently reflect the biologic behavior of meningiomas. This leads to both under-treatment and over-treatment of patients, and hence, suboptimal outcomes (Rogers et al. in Neuro Oncol 18(4):565-574). The goal of this review is to synthesize studies to date investigating molecular features of meningiomas as they relate to patient outcomes, in order to clarify best practices in assessing and, therefore, treating meningiomas. METHODS The available literature of genomic landscape and molecular features of in meningioma was screened using PubMed. RESULTS Greater understanding of meningiomas is reached by integrating histopathology, mutational analysis, DNA copy number changes, DNA methylation profiles, and potentially additional modalities to fully capture the clinical and biologic heterogeneity of these tumors. CONCLUSION Diagnosis and classification of meningioma is best accomplished using a combination of histopathology with genomic and epigenomic factors. Future classification schemes may benefit from such an integrated approach.
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Erson-Omay EZ, Vetsa S, Vasandani S, Barak T, Nadar A, Marianayanam N, Yalcin K, Miyagishima D, Aguilera SM, Robert S, Mishra-Gorur K, Fulbright RK, McGuone D, Günel M, Moliterno J. Genomic profiling of sporadic multiple meningiomas. BMC Med Genomics 2022; 15:112. [PMID: 35568945 PMCID: PMC9107270 DOI: 10.1186/s12920-022-01258-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple meningiomas (MMs) rarely occur sporadically. It is unclear whether each individual tumor in a single patient behaves similarly. Moreover, the molecular mechanisms underlying the formation of sporadic MMs and clonal formation etiology of these tumors are poorly understood. METHODS Patients with spatially separated MMs without prior radiation exposure or a family history who underwent surgical resection of at least two meningiomas were included. Unbiased, comprehensive next generation sequencing was performed, and relevant clinical data was analyzed. RESULTS Fifteen meningiomas and one dural specimen from six patients were included. The majority of tumors (12/15) were WHO Grade I; one patient had bilateral MMs, one of which was Grade II, while the other was Grade I. We found 11/15 of our cohort specimens were of NF2-loss subtype. Meningiomas from 5/6 patients had a monoclonal origin, with the tumor from the remaining patient showing evidence for independent clonal formation. We identified a novel case of non-NF2 mutant MM with monoclonal etiology. MMs due to a monoclonal origin did not always display a homogenous genomic profile, but rather exhibited heterogeneity due to branching evolution. CONCLUSIONS Both NF2-loss and non-NF2 driven MMs can form due to monoclonal expansion and those tumors can acquire inter-tumoral heterogeneity through branched evolution. Grade I and II meningiomas can occur in the same patient. Thus, the molecular make-up and clinical behavior of one tumor in MMs, cannot reliably lend insight into that of the others and suggests the clinical management strategy for MMs should be tailored individually.
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Affiliation(s)
- E. Zeynep Erson-Omay
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA ,grid.417307.6The Susan Beris, MD Neurosurgical Oncology Program at Yale New Haven Hospital, New Haven, CT USA
| | - Shaurey Vetsa
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA ,grid.417307.6The Susan Beris, MD Neurosurgical Oncology Program at Yale New Haven Hospital, New Haven, CT USA
| | - Sagar Vasandani
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA ,grid.417307.6The Susan Beris, MD Neurosurgical Oncology Program at Yale New Haven Hospital, New Haven, CT USA
| | - Tanyeri Barak
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA
| | - Arushii Nadar
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA ,grid.417307.6The Susan Beris, MD Neurosurgical Oncology Program at Yale New Haven Hospital, New Haven, CT USA
| | - Neelan Marianayanam
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA ,grid.417307.6The Susan Beris, MD Neurosurgical Oncology Program at Yale New Haven Hospital, New Haven, CT USA
| | - Kanat Yalcin
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA
| | - Danielle Miyagishima
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA
| | - Stephanie Marie Aguilera
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA
| | - Stephanie Robert
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA ,grid.417307.6The Susan Beris, MD Neurosurgical Oncology Program at Yale New Haven Hospital, New Haven, CT USA
| | - Ketu Mishra-Gorur
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA
| | - Robert K. Fulbright
- grid.47100.320000000419368710Department of Radiology and Biomedical Imaging, Neuroradiology Section, Yale School of Medicine, New Haven, CT USA
| | - Declan McGuone
- grid.47100.320000000419368710Department of Pathology, Yale School of Medicine, New Haven, CT USA
| | - Murat Günel
- grid.47100.320000000419368710Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT 06520-8082 USA ,grid.490524.eThe Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT USA ,grid.417307.6The Susan Beris, MD Neurosurgical Oncology Program at Yale New Haven Hospital, New Haven, CT USA ,grid.47100.320000000419368710Department of Genetics, Yale School of Medicine, New Haven, CT USA
| | - Jennifer Moliterno
- Department of Neurosurgery, Yale School of Medicine, 15 York St, LLCI 810, New Haven, CT, 06520-8082, USA. .,The Chênevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT, USA. .,The Susan Beris, MD Neurosurgical Oncology Program at Yale New Haven Hospital, New Haven, CT, USA.
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Risk of second primary neoplasms of the central nervous system. Adv Radiat Oncol 2022; 7:100969. [PMID: 35814854 PMCID: PMC9260125 DOI: 10.1016/j.adro.2022.100969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/12/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose Second primary (SP) neoplasms of the central nervous system (CNS) among cancer survivors are devastating but poorly understood processes. The absolute risk, or true incidence, of developing an SP CNS tumor among cancer survivors is not well characterized. Methods and Materials Patients diagnosed with cancer between 1975 and 2016 were queried using the Surveillance, Epidemiology, and End Results Program. Cumulative incidence rates (CIRs) were estimated using competitive risk analysis. The effects of covariates were assessed using multivariate competitive risk regression. Results More than 3.8 million patient records were extracted. The absolute risk of developing an SP CNS neoplasm at 25 years was highest among long-term survivors of CNS cancers (CIR, 6.6%). Cranial radiation increased the incidence of SP tumors in pediatric patients (25-year CIR, 5.7% vs 1.1%; P = .0012) but not adults (25-year CIR, 5.8% vs 5.0%; P = .66). Multivariate cumulative risk regression identified radiation among pediatric patients as the greatest risk for an increased CIR (subdistribution hazard ratio, 2.50; 95% CI, 1.86-3.38; P = 2e-9). Meningiomas (42.9% vs 24.1%; P = 2e-7) and glioblastomas (20.5% vs 14.5%; P = .046) represented a greater proportion of the SP CNS tumors in those who received cranial irradiation. The median age of an SP diagnosis was decreased among those who received prior radiation (41 years [interquartile range (IQR), 30-65 years] vs 49 years [IQR, 30-65 years]; P = 7e-5). Conclusions The risk of developing a second primary CNS neoplasm is elevated in patients with a prior CNS cancer independent of treatment history. The association between cranial radiation therapy and risk for subsequent cancers may be limited to the pediatric population.
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Nassiri F, Wang JZ, Au K, Barnholtz-Sloan J, Jenkinson MD, Drummond K, Zhou Y, Snyder JM, Brastianos P, Santarius T, Suppiah S, Poisson L, Gaillard F, Rosenthal M, Kaufmann T, Tsang D, Aldape K, Zadeh G. Consensus core clinical data elements for meningiomas. Neuro Oncol 2021; 24:683-693. [PMID: 34791428 DOI: 10.1093/neuonc/noab259] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND With increasing molecular analyses of meningiomas, there is a need to harmonize language used to capture clinical data across centers to ensure that molecular alterations are appropriately linked to clinical variables of interest. Here the International Consortium on Meningiomas presents a set of core and supplemental meningioma-specific Common Data Elements (CDEs) to facilitate comparative and pooled analyses. METHODS The generation of CDEs followed the four-phase process similar to other National Institute of Neurological Disorders and Stroke (NINDS) CDE projects: discovery, internal validation, external validation, and distribution. RESULTS The CDEs were organized into patient- and tumor-level modules. In total, 17 core CDEs (10 patient-level and 7-tumour-level) as well as 14 supplemental CDEs (7 patient-level and 7 tumour-level) were defined and described. These CDEs are now made publicly available for dissemination and adoption. CONCLUSIONS CDEs provide a framework for discussion in the neuro-oncology community that will facilitate data sharing for collaborative research projects and aid in developing a common language for comparative and pooled analyses. The meningioma-specific CDEs presented here are intended to be dynamic parameters that evolve with time and The Consortium welcomes international feedback for further refinement and implementation of these CDEs.
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Affiliation(s)
- Farshad Nassiri
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Justin Z Wang
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Karolyn Au
- Division of Neurosurgery, Department of Surgery, University of Alberta, AB, Canada
| | - Jill Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Michael D Jenkinson
- Department of Neurosurgery, University of Liverpool, England, United Kingdom
| | - Kate Drummond
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, Australia
| | - Yueren Zhou
- Henry Ford Health System, Detroit, MI, United States
| | | | - Priscilla Brastianos
- Dana Farber/Harvard Cancer Center, Massachusetts General Hospital, Boston, MA, United States
| | - Thomas Santarius
- Department of Neurosurgery, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Suganth Suppiah
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Laila Poisson
- Henry Ford Health System, Detroit, MI, United States
| | - Francesco Gaillard
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Mark Rosenthal
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Timothy Kaufmann
- Department of Radiology, The Mayo Clinic, Rochester, Min, United States
| | - Derek Tsang
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Kenneth Aldape
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Gelareh Zadeh
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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13
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Bunevicius A, Suleiman M, Patel S, Martínez Álvarez R, Martinez Moreno NE, Liscak R, Hanuska J, Langlois AM, Mathieu D, Mau C, Caldwell C, Tuanquin LC, Zacharia BE, McInerney J, Lee CC, Yang HC, Peterson JL, Trifiletti DM, Ogino A, Kano H, Warnick RE, Saylany A, Buch LY, Lee JYK, Strickland BA, Zada G, Chang EL, Lunsford LD, Sheehan J. Stereotactic radiosurgery for treatment of radiation-induced meningiomas: a multiinstitutional study. J Neurosurg 2021; 135:862-870. [PMID: 33385995 DOI: 10.3171/2020.7.jns202064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/14/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Radiation-induced meningiomas (RIMs) are associated with aggressive clinical behavior. Stereotactic radiosurgery (SRS) is sometimes considered for selected RIMs. The authors investigated the effectiveness and safety of SRS for the management of RIMs. METHODS From 12 institutions participating in the International Radiosurgery Research Foundation, the authors pooled patients who had prior cranial irradiation and were subsequently clinically diagnosed with WHO grade I meningiomas that were managed with SRS. RESULTS Fifty-two patients underwent 60 SRS procedures for histologically confirmed or radiologically suspected WHO grade I RIMs. The median ages at initial cranial radiation therapy and SRS for RIM were 5.5 years and 39 years, respectively. The most common reasons for cranial radiation therapy were leukemia (21%) and medulloblastoma (17%). There were 39 multiple RIMs (35%), the mean target volume was 8.61 ± 7.80 cm3, and the median prescription dose was 14 Gy. The median imaging follow-up duration was 48 months (range 4-195 months). RIM progressed in 9 patients (17%) at a median duration of 30 months (range 3-45 months) after SRS. Progression-free survival at 5 years post-SRS was 83%. Treatment volume ≥ 5 cm3 predicted progression (HR 8.226, 95% CI 1.028-65.857, p = 0.047). Seven patients (14%) developed new neurological symptoms or experienced SRS-related complications or T2 signal change from 1 to 72 months after SRS. CONCLUSIONS SRS is associated with durable local control of RIMs in the majority of patients and has an acceptable safety profile. SRS can be considered for patients and tumors that are deemed suboptimal, poor surgical candidates, and those whose tumor again progresses after removal.
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Affiliation(s)
- Adomas Bunevicius
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Mohand Suleiman
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Samir Patel
- 2Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Roman Liscak
- 4Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
| | - Jaromir Hanuska
- 4Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
| | - Anne-Marie Langlois
- 5Division of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | - David Mathieu
- 5Division of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | - Christine Mau
- 6Penn State Health, Hershey Medical Center, Hershey, Pennsylvania
| | | | | | - Brad E Zacharia
- 6Penn State Health, Hershey Medical Center, Hershey, Pennsylvania
| | - James McInerney
- 6Penn State Health, Hershey Medical Center, Hershey, Pennsylvania
| | - Cheng-Chia Lee
- 7Neurological Institute, Taipei Veterans General Hospital, and National Yang-Ming University, Taipei, Taiwan
| | - Huai-Che Yang
- 7Neurological Institute, Taipei Veterans General Hospital, and National Yang-Ming University, Taipei, Taiwan
| | | | | | - Akiyoshi Ogino
- 9Department of Neurologic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Hideyuki Kano
- 9Department of Neurologic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Anissa Saylany
- 11Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Love Y Buch
- 11Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - John Y K Lee
- 11Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | | | - Gabriel Zada
- 12University of Southern California, Los Angeles, California
| | - Eric L Chang
- 12University of Southern California, Los Angeles, California
| | - L Dade Lunsford
- 9Department of Neurologic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jason Sheehan
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
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14
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Gillespie CS, Islim AI, Taweel BA, Millward CP, Kumar S, Rathi N, Mehta S, Haylock BJ, Thorp N, Gilkes CE, Lawson DDA, Mills SJ, Chavredakis E, Farah JO, Brodbelt AR, Jenkinson MD. The growth rate and clinical outcomes of radiation induced meningioma undergoing treatment or active monitoring. J Neurooncol 2021; 153:239-249. [PMID: 33886110 PMCID: PMC8211577 DOI: 10.1007/s11060-021-03761-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 04/15/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Radiation induced meningioma (RIM) incidence is increasing in line with improved childhood cancer survival. No optimal management strategy consensus exists. This study aimed to delineate meningioma growth rates from tumor discovery and correlate with clinical outcomes. METHODS Retrospective study of patients with a RIM, managed at a specialist tertiary neuroscience center (2007-2019). Tumor volume was measured from diagnosis and at subsequent interval scans. Meningioma growth rate was determined using a linear mixed-effects model. Clinical outcomes were correlated with growth rates accounting for imaging and clinical prognostic factors. RESULTS Fifty-four patients (110 meningiomas) were included. Median duration of follow-up was 74 months (interquartile range [IQR], 41-102 months). Mean radiation dose was 41 Gy (standard deviation [SD] = 14.9) with a latency period of 34.4 years (SD = 13.7). Median absolute growth rate was 0.62 cm3/year and the median relative growth rate was 72%/year. Forty meningiomas (between 27 patients) underwent surgical intervention after a median follow-up duration of 4 months (IQR 2-35). Operated RIMs were clinically aggressive, likely to be WHO grade 2 at first resection (43.6%) and to progress after surgery (41%). Median time to progression was 28 months (IQR 13-60.5). A larger meningioma at discovery was associated with growth (HR 1.2 [95% CI 1.0-1.5], P = 0.039) but not progression after surgery (HR 2.2 [95% CI 0.7-6.6], P = 0.181). Twenty-seven (50%) patients had multiple meningiomas by the end of the study. CONCLUSION RIMs exhibit high absolute and relative growth rates after discovery. Surgery is recommended for symptomatic or rapidly growing meningiomas only. Recurrence risk after surgery is high.
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Affiliation(s)
- Conor S Gillespie
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK. .,The Walton Centre NHS Foundation Trust, Liverpool, UK. .,School of Medicine, University of Liverpool, Cedar House, Ashton Street, Liverpool, L69 3GE, UK.
| | - Abdurrahman I Islim
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Basel A Taweel
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | | | - Nitika Rathi
- The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Shaveta Mehta
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Brian J Haylock
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Nicola Thorp
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | | | | | | | | | | | | | - Michael D Jenkinson
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
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15
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Abstract
Radiation-induced meningiomas (RIMs) became more common as the use of ionizing radiation was adopted in the treatment of medical conditions, both benign and malignant. Currently, RIMs represent the most common radiation-induced tumors. They are heterogeneous in terms of patient characteristics, radiographic appearance, genetics, pathology, symptoms, and management strategies. They tend to occur in a younger population and are generally more aggressive in nature than their spontaneous counterparts. Their characteristics also vary based on the dose of radiation received, which is most commonly separated into low dose (<10Gy) and high dose (>10Gy). The importance of the dosing classification is that it can provide insight into the nature and biologic behavior of the tumor. Given their heterogeneity, RIMs pose significant challenges in management. While surgical resection remains the preferred treatment when feasible, recent data supports stereotactic radiosurgery (SRS) as a comparable alternative. Although there is more knowledge about the molecular pathways leading to RIMs, targeted drug therapy is still limited and is the focus of current research.
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16
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Toland A, Huntoon K, Dahiya SM. Meningioma: A Pathology Perspective. Neurosurgery 2021; 89:11-21. [PMID: 33588439 DOI: 10.1093/neuros/nyab001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022] Open
Abstract
Meningiomas are dural-based neoplasms that account for ∼37% of all intracranial tumors in the adult population. They can occur anywhere within the central nervous system and have a predilection for females. The World Health Organization classifies meningiomas into 3 grades based on increased risk of recurrence and associated mortality in grade III tumors. Although most tumors are categorized as low-grade, up to ∼15%-20% demonstrate more aggressive behavior. With the long-recognized association with neurofibromatosis type 2 gene mutation, putative driver mutations can be attributed to ∼80% of tumors. Several germline mutations have also been identified in some cases of familial meningiomatosis such as SMARCE1, SUFU, PTEN, and BAP1. Finally, in addition to genetic data, epigenetic alterations, specifically deoxyribonucleic acid methylation, are being increasingly recognized for their prognostic value, potentially adding objectivity to a currently subjective grading scheme.
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Affiliation(s)
- Angus Toland
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Kristin Huntoon
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Sonika M Dahiya
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
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17
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Huo M, Laperriere N, van Prooijen M, Shultz D, Coolens C, Hodaie M, Cusimano M, Gentili F, Zadeh G, Payne D, Schwartz M, Tsang DS. Efficacy of stereotactic radiosurgery for radiation-induced meningiomas. J Neurooncol 2020; 148:299-305. [PMID: 32342330 DOI: 10.1007/s11060-020-03515-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/22/2020] [Indexed: 01/24/2023]
Abstract
PURPOSE Stereotactic radiosurgery is an established treatment option for sporadic meningiomas, though limited data exists for radiation-induced lesions. METHODS Patients treated with cobalt-60 radiosurgery between October 2005 and December 2018 in an institutional registry were reviewed. Single fraction treatments were prescribed to the 50% isodose line. Lesions were deemed to be radiation-induced according to standard criteria previously established by Cahan et al. RESULTS: A total of 37 patients with 72 lesions were analysed. Median follow up per patient was 44 months (range, 1.4-150.7 months). Median age at initial radiotherapy was 5 years (4 months-48 years), and at radiosurgery was 38 years. Of the 72 lesions, 62 were grade 1 (n = 4) or radiologically-diagnosed (n = 58), six were grade 2 and four were grade 3. Median lesion volume was 2.13 cc (0.04-13.8 cc), while the median radiosurgery margin dose was 13 Gy. Local control, on a per lesion basis, was 88.6% at 5 years (95% confidence interval [CI] 72.3-95.6). For grade 1 or radiologically-diagnosed lesions, local control was 96.6% at 5 years (95% CI 77.9-99.5), whereas those with grade 2 or higher lesions had a local control of 40% at 5 years (95% CI 5.2-75.3, p = 0.005). Radiologic oedema developed in 17 lesions (23.6%) and was symptomatic in 12 patients (16.7%). Doses above 12 Gy were not associated with local control probability (p = 0.292). CONCLUSION Radiosurgery is an effective treatment option for grade 1 or radiologically-diagnosed radiation-induced meningiomas, with 12 Gy appearing to be a sufficient dose.
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Affiliation(s)
- Michael Huo
- Princess Margaret Cancer Centre, Toronto, Canada. .,The University of Toronto, Toronto, Canada. .,The University of Queensland, Brisbane, Australia.
| | - Normand Laperriere
- Princess Margaret Cancer Centre, Toronto, Canada.,The University of Toronto, Toronto, Canada
| | - Monique van Prooijen
- Princess Margaret Cancer Centre, Toronto, Canada.,The University of Toronto, Toronto, Canada
| | - David Shultz
- Princess Margaret Cancer Centre, Toronto, Canada.,The University of Toronto, Toronto, Canada
| | - Catherine Coolens
- Princess Margaret Cancer Centre, Toronto, Canada.,The University of Toronto, Toronto, Canada
| | - Mojgan Hodaie
- The University of Toronto, Toronto, Canada.,Toronto Western Hospital, Toronto, Canada
| | - Michael Cusimano
- The University of Toronto, Toronto, Canada.,St Michael's Hospital, Toronto, Canada
| | - Fred Gentili
- The University of Toronto, Toronto, Canada.,Toronto Western Hospital, Toronto, Canada
| | - Gelareh Zadeh
- The University of Toronto, Toronto, Canada.,Toronto Western Hospital, Toronto, Canada
| | - David Payne
- Princess Margaret Cancer Centre, Toronto, Canada.,The University of Toronto, Toronto, Canada
| | - Michael Schwartz
- The University of Toronto, Toronto, Canada.,Toronto Western Hospital, Toronto, Canada
| | - Derek S Tsang
- Princess Margaret Cancer Centre, Toronto, Canada.,The University of Toronto, Toronto, Canada
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18
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Fujii M, Ichikawa M, Iwatate K, Bakhit M, Yamada M, Kuromi Y, Sato T, Sakuma J, Sato H, Kikuta A, Suzuki Y, Saito K. Secondary brain tumors after cranial radiation therapy: A single-institution study. Rep Pract Oncol Radiother 2020; 25:245-249. [PMID: 32071561 DOI: 10.1016/j.rpor.2020.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/08/2019] [Accepted: 01/27/2020] [Indexed: 12/29/2022] Open
Abstract
Aim To study the probability of developing secondary brain tumors after cranial radiotherapy.Background Patients treated with cranial radiotherapy are at risk for developing secondary brain tumors. Patients and methods We planned an institutional survey for secondary brain tumors in survivors after cranial irradiation and reviewed the 30-year duration data. Event analysis and cumulative proportion curves were performed to generally estimate the cumulative proportion of developing secondary brain tumors, cavernoma and meningioma at different periods of time. Results Secondary brain tumors occurred in 21% of cases: 10% were cavernomas, 6% were meningiomas, 3% were skull osteomas, and 1% were anaplastic astrocytoma. The cumulative proportion of developing secondary brain tumor was 6% at 10 years and 20% at 20 years, while the cumulative proportion for developing cavernomas and meningiomas was 16% and 7% at 20 years, respectively. Conclusion Our study shows that patients who received cranial irradiation were at risk of secondary brain tumors such as cavernomas and meningiomas. Thus, a meticulous follow-up of cancer survivors with history of cranial irradiation by an annual MRI scan is justifiable. This will help clinicians to detect secondary brain tumors early and make its management much easier.
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Affiliation(s)
- Masazumi Fujii
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Masahiro Ichikawa
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Kensho Iwatate
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Mudathir Bakhit
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Masayuki Yamada
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Yosuke Kuromi
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Taku Sato
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Jun Sakuma
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Hisashi Sato
- Department of Radiation Oncology, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Yoshiyuki Suzuki
- Department of Radiation Oncology, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
| | - Kiyoshi Saito
- Department of Neurosurgery, Fukushima Medical University, Fukushima prefecture, Fukushima City, Japan
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19
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Yamanaka R, Abe E, Sato T, Hayano A, Takashima Y. Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review. Cancers (Basel) 2017; 9:cancers9080103. [PMID: 28786923 PMCID: PMC5575606 DOI: 10.3390/cancers9080103] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 02/02/2023] Open
Abstract
Pituitary adenomas are often treated with radiotherapy for the management of tumor progression or recurrence. Despite the improvement in cure rates, patients treated by radiotherapy are at risk of development of secondary malignancies. We conducted a comprehensive literature review of the secondary intracranial tumors that occurred following radiotherapy to pituitary adenomas to obtain clinicopathological characteristics. The analysis included 48 neuroepithelial tumors, 37 meningiomas, and 52 sarcomas which were published between 1959–2017, although data is missing regarding overall survival and type of irradiation in a significant proportion of the reports. The average onset age for the pituitary adenoma was 37.2 ± 14.4 years and the average latency period before the diagnosis of the secondary tumor was 15.2 ± 8.7 years. Radiotherapy was administered in pituitary adenomas at an average dose of 52.0 ± 19.5 Gy. The distribution of pituitary adenomas according to their function was prolactinoma in 10 (7.2%) cases, acromegaly in 37 (27.0%) cases, Cushing disease in 4 (2.9%) cases, PRL+GH in 1 (0.7%) case, non-functioning adenoma in 57 (41.6%) cases. Irradiation technique delivered was lateral opposing field in 23 (16.7%) cases, 3 or 4 field technique in 27 (19.6%) cases, rotation technique in 10 (7.2%) cases, radio surgery in 6 (4.3%) cases. Most of the glioma or sarcoma had been generated after lateral opposing field or 3/4 field technique. Fibrosarcomas were predominant before 1979 (p < 0.0001). The median overall survival time for all neuroepithelial tumors was 11 months (95% confidence intervals (CI), 3–14). Patients with gliomas treated with radiotherapy exhibited a non-significant positive trend with longer overall survival. The median overall survival time for sarcoma cases was 6 months (95% CI, 1.5–9). The median survival time in patients with radiation and/or chemotherapy for sarcomas exhibited a non-significant positive trend with longer overall survival. In patients treated with radiotherapy for pituitary adenomas, the risk of secondary tumor incidence warrants a longer follow up period. Moreover, radiation and/or chemotherapy should be considered in cases of secondary glioma or sarcoma following radiotherapy to the pituitary adenomas.
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Affiliation(s)
- Ryuya Yamanaka
- Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
| | - Eisuke Abe
- Division of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8122, Japan.
| | - Toshiteru Sato
- Department of Radiology, Nagaoka Chuo General Hospital, Nagaoka 940-8653, Japan.
| | - Azusa Hayano
- Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
| | - Yasuo Takashima
- Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
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20
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Agnihotri S, Suppiah S, Tonge PD, Jalali S, Danesh A, Bruce JP, Mamatjan Y, Klironomos G, Gonen L, Au K, Mansouri S, Karimi S, Sahm F, von Deimling A, Taylor MD, Laperriere NJ, Pugh TJ, Aldape KD, Zadeh G. Therapeutic radiation for childhood cancer drives structural aberrations of NF2 in meningiomas. Nat Commun 2017; 8:186. [PMID: 28775249 PMCID: PMC5543118 DOI: 10.1038/s41467-017-00174-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 06/07/2017] [Indexed: 11/09/2022] Open
Abstract
Cranial radiotherapy improves survival of the most common childhood cancers, including brain tumors and leukemia. Unfortunately, long-term survivors are faced with consequences of secondary neoplasia, including radiation-induced meningiomas (RIMs). We characterized 31 RIMs with exome/NF2 intronic sequencing, RNA sequencing and methylation profiling, and found NF2 gene rearrangements in 12/31 of RIMs, an observation previously unreported in sporadic meningioma (SM). Additionally, known recurrent mutations characteristic of SM, including AKT1, KLF4, TRAF7 and SMO, were not observed in RIMs. Combined losses of chromosomes 1p and 22q were common in RIMs (16/18 cases) and overall, chromosomal aberrations were more complex than that observed in SM. Patterns of DNA methylation profiling supported similar cell of origin between RIMs and SMs. The findings indicate that the mutational landscape of RIMs is distinct from SMs, and have significant therapeutic implications for survivors of childhood cranial radiation and the elucidation of the molecular pathogenesis of meningiomas. Radiation-induced meningiomas are often more aggressive than sporadic ones. In this study, the authors perform an exome, methylation and RNA-seq analysis of 31 cases of radiation-induced meningioma and show NF2 rearrangement, an observation previously unreported in the sporadic tumors.
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Affiliation(s)
- Sameer Agnihotri
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7
| | - Suganth Suppiah
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7.,Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, ON, Canada, M5S 1A8
| | - Peter D Tonge
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7.,Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9
| | - Shahrzad Jalali
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7.,Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9
| | - Arnavaz Danesh
- Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9
| | - Jeffery P Bruce
- Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9
| | - Yasin Mamatjan
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7.,Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9
| | - George Klironomos
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7
| | - Lior Gonen
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7
| | - Karolyn Au
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7
| | - Sheila Mansouri
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7.,Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9
| | - Sharin Karimi
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada, M5S 1A8
| | - Felix Sahm
- Department of Neuropathology, Institute of PathologyUniversity Hospital Heidelberg, Heidelberg, 69120, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK) German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Institute of PathologyUniversity Hospital Heidelberg, Heidelberg, 69120, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK) German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | - Michael D Taylor
- Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, ON, Canada, M5S 1A8.,Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9.,Developmental & Stem Cell Biology Program, Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada, M5G 1L7
| | - Normand J Laperriere
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7.,Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9
| | - Trevor J Pugh
- Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9.,Developmental & Stem Cell Biology Program, Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada, M5G 1L7
| | - Kenneth D Aldape
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7. .,Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9. .,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada, M5S 1A8.
| | - Gelareh Zadeh
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, M5G 1L7. .,Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, ON, Canada, M5S 1A8. .,Princess Margaret Cancer Centre, Toronto, ON, Canada, M5G 2M9.
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Raheja A, Satyarthee GD. Sphenoid wing en plaque meningioma development following craniopharyngioma surgery and radiotherapy: Radiation-induced after three decades. Asian J Neurosurg 2017; 12:358-361. [PMID: 28761508 PMCID: PMC5532915 DOI: 10.4103/1793-5482.180946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Radiation therapy is widely used as adjuvant or primary treatment modality of neoplastic lesions. Radiation therapy may cause an acute adverse effect such as brain edema, radiation necrosis, or delayed, for example, panhypopituitarism, vasculitis, and rare de-novo neoplasm development. However, radiation-induced meningioma (RIM) occurrence is extremely rare. A detailed PubMed and Medline search yielded only three isolated Case-reports of RIM development in craniopharyngioma cases receiving radiotherapy after surgery. All cases occurred in patients < 13-year age, with male preponderance, detected after a mean interval of 23-year, the range being 2–44 years. Two had solitary while the third had multiple meningiomas. Authors report an 8-year-old female, who was operated for craniopharyngioma and received adjuvant therapy, was asymptomatic for next 30 years, met a road traffic accident and magnetic resonance imaging brain revealed incidental right sphenoid wing en plaque meningioma. She was planned for gamma-knife therapy as unwilling for surgical intervention. Management of RIM development after radiotherapy of craniopharyngioma along with pertinent literature is reviewed briefly.
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Affiliation(s)
- Amol Raheja
- Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India
| | - Guru Dutta Satyarthee
- Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India
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22
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Liu H, Li Y, Li Y, Zhou L, Bie L. STMN1 as a candidate gene associated with atypical meningioma progression. Clin Neurol Neurosurg 2017. [DOI: 10.1016/j.clineuro.2017.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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23
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Szymanski LJ, Sibug Saber ME, Kim JW, Go JL, Zada G, Rao N, Hurth KM. Quadruple Neoplasms following Radiation Therapy for Congenital Bilateral Retinoblastoma. Ocul Oncol Pathol 2017; 4:33-37. [PMID: 29344496 DOI: 10.1159/000477410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/09/2017] [Indexed: 01/30/2023] Open
Abstract
Purpose The aim of this study was to describe a 34-year-old male with hereditary bilateral retinoblastoma treated with radiotherapy as a child who developed 4 distinct tumors within the radiation field. Methods A 34-year-old male with bilateral retinoblastoma status postradiation therapy and recurrence requiring enucleation presented with left-eye visual acuity changes. Magnetic resonance imaging demonstrated a left orbital mass and a right parasellar complex lobulated mass (right sphenoid and right cavernous sinus). Two weeks later, the patient underwent excision of the orbital mass and biopsy of an upper-lid nodule. This was followed by craniotomy for removal of the complex mass. Results Histology revealed 4 distinct tumors, including an undifferentiated pleomorphic sarcoma (left orbit), a radiation-induced meningioma (right sphenoid), a schwannoma (right cavernous sinus), and a basal-cell carcinoma (left lid). Conclusion Although occurrence of a second neoplasm is a well-known outcome following radiation treatment in patients with hereditary retinoblastoma, the diagnosis of 4 additional neoplasms is rare. Pleomorphic sarcoma, radiation-induced meningioma, and schwannoma are uncommon tumors and not well represented in the literature describing irradiated retinoblastoma patients. Secondary malignancies are a leading cause of early death in retinoblastoma survivors, and long-term follow-up is crucial for patient care.
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Affiliation(s)
- Linda J Szymanski
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Maria E Sibug Saber
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.,Department of Opthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Jonathan W Kim
- Department of Opthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - John L Go
- Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Gabriel Zada
- Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Narsing Rao
- Department of Opthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Kyle M Hurth
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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24
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Sahm F, Toprak UH, Hübschmann D, Kleinheinz K, Buchhalter I, Sill M, Stichel D, Schick M, Bewerunge-Hudler M, Schrimpf D, Zadeh G, Aldape K, Herold-Mende C, Beck K, Staszewski O, Prinz M, Harosh CB, Eils R, Sturm D, Jones DTW, Pfister SM, Paulus W, Ram Z, Schlesner M, Grossman R, von Deimling A. Meningiomas induced by low-dose radiation carry structural variants of NF2 and a distinct mutational signature. Acta Neuropathol 2017; 134:155-158. [PMID: 28474103 DOI: 10.1007/s00401-017-1715-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 04/21/2017] [Accepted: 04/21/2017] [Indexed: 10/19/2022]
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25
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Radiation-Induced Meningiomas: An Exhaustive Review of the Literature. World Neurosurg 2016; 97:635-644.e8. [PMID: 27713063 DOI: 10.1016/j.wneu.2016.09.094] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/18/2016] [Accepted: 09/23/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Radiation-induced meningioma (RIM) is an uncommon late risk of cranial irradiation. We conducted an exhaustive review of individual patient data to characterize RIM. METHODS Using a systematic search of the PubMed database, we performed a comprehensive literature review to characterize and investigate RIM. Student t tests were used to evaluate differences between variables. A Kaplan-Meier analysis was used to assess survival. Statistical significance was assessed using a log-rank test. RESULTS Our analysis included 251 cases of RIM. The average age at onset for the primary lesion was 13.0 ± 13.5 years, and the average radiation dose delivered to this lesion was 38.8 ± 16.8 Gy. Secondary meningiomas could be divided into grades I (140), II (55), and III (10) tumors. Thirty patients (11.9%) had multiple lesions, and 46 (18.3%) had recurrent meningiomas. The latency period between radiotherapy for primary lesions and the onset of meningiomas was 22.9 ± 11.4 years. The latency period was shorter for patients with grade III meningioma and for those in the high-dose and intermediate-dose radiation groups who received systemic chemotherapy. Aggressive meningiomas and multiple meningiomas were more common in the high-dose and intermediate-dose groups than in the low-dose group. The 5-year and 10-year survival rates for all patients with meningioma were 77.7% and 66.1%, respectively. CONCLUSIONS For patients treated with cranial radiotherapy, the risk of secondary meningioma warrants a longer follow-up period beyond the standard time frame typically designated for determining the risk of primary tumor relapse.
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26
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Begnami MD, Rushing EJ, Santi M, Quezado M. Evaluation of NF2 Gene Deletion in Pediatric Meningiomas Using Chromogenic In Situ Hybridization. Int J Surg Pathol 2016; 15:110-5. [PMID: 17478763 DOI: 10.1177/1066896906299128] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Meningiomas are uncommon childhood tumors. They could be of significant size at presentation, which has been associated with difficult surgical excision, high recurrence rate, and possibly aggressive clinical behavior. Monosomy 22 is a common molecular event in this neoplasm. Additionally, losses on chromosomes 1,7,10, and 14 have been identified in clinically aggressive meningiomas. Using chromogenic in situ hybridization, we studied a group of pediatric meningiomas, including neurofibromatosis type II—associated, sporadic, and radiation-induced cases. We found NF2 gene deletion in about 72% of the cases, with corresponding absent or minimal merlin protein expression by immunohistochemistry. Our findings confirm that the NF2 gene plays a role in the tumorigenesis of pediatric meningiomas and that chromogenic in situ hybridization is an efficient, economic, and reliable method for routinely assessing NF2 gene deletion in formalin-fixed, paraffin-embedded tissues.
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Affiliation(s)
- Maria D Begnami
- Laboratory of Pathology, Surgical Pathology Section, National Cancer Institute, NIH, Bethesda, Maryland, USA
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27
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Radiation-associated grade 2 meningiomas: A nine patient-series and review of the literature. Clin Neurol Neurosurg 2015; 136:10-4. [DOI: 10.1016/j.clineuro.2015.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 05/17/2015] [Accepted: 05/18/2015] [Indexed: 11/17/2022]
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28
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Bishitz Y, Ozana N, Beiderman Y, Tenner F, Schmidt M, Mico V, Garcia J, Zalevsky Z. Noncontact optical sensor for bone fracture diagnostics. BIOMEDICAL OPTICS EXPRESS 2015; 6:651-7. [PMID: 25798293 PMCID: PMC4361423 DOI: 10.1364/boe.6.000651] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/13/2014] [Accepted: 12/18/2014] [Indexed: 05/20/2023]
Abstract
We present the first steps of a device suitable for detection of broken and cracked bones. The approach is based on temporal tracking of back reflected secondary speckle patterns generated when illuminating the limb with a laser and while applying periodic pressure stimulation via a loud speaker. Preliminary experiments are included showing the validity of the proposed device for detection of damaged bones.
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Affiliation(s)
- Yael Bishitz
- Faculty of Engineering, Bar-Ilan University, Ramat-Gan 52900,
Israel
- These authors contributed equally to the paper
| | - Nisan Ozana
- Faculty of Engineering, Bar-Ilan University, Ramat-Gan 52900,
Israel
- These authors contributed equally to the paper
| | - Yevgeny Beiderman
- Faculty of Engineering, Bar-Ilan University, Ramat-Gan 52900,
Israel
| | - Felix Tenner
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen,
Germany
- Graduate School in Advanced Optical Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen,
Germany
| | - Michael Schmidt
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen,
Germany
- Graduate School in Advanced Optical Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen,
Germany
| | | | | | - Zeev Zalevsky
- Faculty of Engineering, Bar-Ilan University, Ramat-Gan 52900,
Israel
- Graduate School in Advanced Optical Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen,
Germany
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29
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Boldrin E, Rumiato E, Fassan M, Cappellesso R, Rugge M, Chiarion-Sileni V, Ruol A, Alfieri R, Cagol M, Castoro C, Amadori A, Saggioro D. Genetic features of metachronous esophageal cancer developed in Hodgkin's lymphoma or breast cancer long-term survivors: an exploratory study. PLoS One 2015; 10:e0117070. [PMID: 25611972 PMCID: PMC4303414 DOI: 10.1371/journal.pone.0117070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/18/2014] [Indexed: 01/13/2023] Open
Abstract
Background Development of novel therapeutic drugs and regimens for cancer treatment has led to improvements in patient long-term survival. This success has, however, been accompanied by the increased occurrence of second primary cancers. Indeed, patients who received regional radiotherapy for Hodgkin’s Lymphoma (HL) or breast cancer may develop, many years later, a solid metachronous tumor in the irradiated field. Despite extensive epidemiological studies, little information is available on the genetic changes involved in the pathogenesis of these solid therapy-related neoplasms. Methods Using microsatellite markers located in 7 chromosomal regions frequently deleted in sporadic esophageal cancer, we investigated loss of heterozygosity (LOH) and microsatellite instability (MSI) in 46 paired (normal and tumor) samples. Twenty samples were of esophageal carcinoma developed in HL or breast cancer long-term survivors: 14 squamous cell carcinomas (ESCC) and 6 adenocarcinomas (EADC), while 26 samples, used as control, were of sporadic esophageal cancer (15 ESCC and 11 EADC). Results We found that, though the overall LOH frequency at the studied chromosomal regions was similar among metachronous and sporadic tumors, the latter exhibited a statistically different higher LOH frequency at 17q21.31 (p = 0.018). By stratifying for tumor histotype we observed that LOH at 3p24.1, 5q11.2 and 9p21.3 were more frequent in ESCC than in EADC suggesting a different role of the genetic determinants located nearby these regions in the development of the two esophageal cancer histotypes. Conclusions Altogether, our results strengthen the genetic diversity among ESCC and EADC whether they occurred spontaneously or after therapeutic treatments. The presence of histotype-specific alterations in esophageal carcinoma arisen in HL or breast cancer long-term survivors suggests that their transformation process, though the putative different etiological origin, may retrace sporadic ESCC and EADC carcinogenesis.
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Affiliation(s)
- Elisa Boldrin
- Immunology and Molecular Oncology, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
| | - Enrica Rumiato
- Immunology and Molecular Oncology, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
| | - Matteo Fassan
- Department of Medicine, Surgical Pathology and Cytopathology, University of Padova, Padova, Italy
| | - Rocco Cappellesso
- Department of Medicine, Surgical Pathology and Cytopathology, University of Padova, Padova, Italy
| | - Massimo Rugge
- Department of Medicine, Surgical Pathology and Cytopathology, University of Padova, Padova, Italy
| | | | - Alberto Ruol
- Department of Surgical Sciences, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Rita Alfieri
- Oncological Surgery, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
| | - Matteo Cagol
- Oncological Surgery, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
| | - Carlo Castoro
- Oncological Surgery, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
| | - Alberto Amadori
- Immunology and Molecular Oncology, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
- Department of Surgical Sciences, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Daniela Saggioro
- Immunology and Molecular Oncology, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
- * E-mail:
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Ogbonnaya ES, Peev N, Nagaraja S, Dardis R. Double trouble: a tale of two radio-treatments. BMJ Case Rep 2014; 2014:bcr-2014-205922. [PMID: 25239997 DOI: 10.1136/bcr-2014-205922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In recent years, an increasing number of patients are treated with radiation. In the early era of radiotherapy, which began soon after X-rays were discovered by Roentgen in 1895, tumours were irradiated with high doses of X-rays in a single fraction. The major initial setback was the damage caused to normal tissues; however, in recent times the use of stereotactic radiosurgery, which delivers high doses of radiation precisely to abnormal tissue targets while sparing the surrounding normal brain tissue, and particularly for surgically inaccessible tumours, has taken centre stage. Prophylactic whole brain radiation (in conjunction with aggressive chemotherapy) for childhood acute lymphoblastic leukaemia has been shown to improve patient survival, however, this is associated with complications in survivors. We report an interesting case of one of the longest survivors who has had double complications from radiotherapy-based interventions.
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Affiliation(s)
- Ebere Sunny Ogbonnaya
- Department of Neurosurgery, University Hospital Coventry and Warwickshire, Coventry, Coventry, UK
| | - Nikolay Peev
- Department of Neurosurgery, Salford Royal Hospital, Manchester, Manchester, UK
| | - Sanjoy Nagaraja
- Department of Radiology, University Hospital Coventry and Warwickshire, Coventry, Coventry, UK
| | - Ronan Dardis
- Department of Neurosurgery, University Hospital Coventry and Warwickshire, Coventry, Coventry, UK
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Risk of second benign brain tumors among cancer survivors in the surveillance, epidemiology, and end results program. Cancer Causes Control 2014; 25:659-68. [PMID: 24682745 DOI: 10.1007/s10552-014-0367-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 03/12/2014] [Indexed: 01/06/2023]
Abstract
PURPOSE To assess risk of developing a second benign brain tumor in a nationwide population of cancer survivors. METHODS We evaluated the risk of developing second benign brain tumors among 2,038,074 1-year minimum cancer survivors compared to expected risk in the general population between 1973 and 2007 in nine population-based cancer registries in the NCI's surveillance, epidemiology, and end results program. Excess risk was estimated using standardized incidence ratios (SIRs) for all second benign brain tumors and specifically for second meningiomas and acoustic neuromas diagnosed during 2004-2008. RESULTS 1,025 patients were diagnosed with a second primary benign brain tumor, of which second meningiomas composed the majority (n = 745). Statistically significant increases in risk of developing a second meningioma compared to the general population were observed following first cancers of the brain [SIR = 19.82; 95 % confidence interval (CI) 13.88-27.44], other central nervous system (CNS) (SIR = 9.54; CI 3.10-22.27), thyroid (SIR = 2.05; CI 1.47-2.79), prostate (SIR = 1.21; CI 1.02-1.43), and acute lymphocytic leukemia (ALL) (SIR = 42.4; CI 23.18-71.13). Statistically significant decreases in risk were observed following first cancers of the uterine corpus (SIR = 0.63; CI 0.42-0.91) and colon (SIR = 0.56; CI 0.37-0.82). Differences in risk between patients initially treated with radiotherapy versus non-irradiated patients were statistically significant for second meningioma after primary cancers of the brain (p Het < 0.001) and ALL (p Het = 0.02). No statistically significant increased risks were detected for second acoustic neuromas (n = 114) following any first primary tumor. CONCLUSIONS Risk of second benign brain tumors, particularly meningioma, is increased following first primary cancers of the brain/CNS, thyroid, prostate, and ALL. Radiation exposure likely contributes to these excess risks.
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Tabernero M, Jara-Acevedo M, Nieto AB, Caballero AR, Otero A, Sousa P, Gonçalves J, Domingues PH, Orfao A. Association between mutation of the NF2 gene and monosomy 22 in menopausal women with sporadic meningiomas. BMC MEDICAL GENETICS 2013; 14:114. [PMID: 24171707 PMCID: PMC3818970 DOI: 10.1186/1471-2350-14-114] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/28/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Meningioma was the first solid tumor shown to contain a recurrent genetic alteration e.g. monosomy 22/del(22q), NF2 being the most relevant gene involved. Although monosomy 22/del(22q) is present in half of all meningiomas, and meningiomas frequently carry NF2 mutations, no study has been reported so far in which both alterations are simultaneously assessed and correlated with the features of the disease. METHODS Here, we analyzed the frequency of both copy number changes involving chromosome 22 and NF2 mutations in 20 sporadic meningiomas using high-density SNP-arrays, interphase-FISH and PCR techniques. RESULTS Our results show a significant frequency of NF2 mutations (6/20 patients, 30%), most of which (5/6) had not been previously reported in sporadic meningiomas. NF2 mutations involved five different exons and led to a truncated protein (p.Leu163CysfsX46, p.Phe62LeufsX61, p.Asp281MetfsX15, p.Phe285LeufsX11, p.Gln389ArgfsX37) and an in frame deletion of Phe119. Interestingly, all NF2 mutated cases were menopausal women with monosomy 22 but not del(22q). CONCLUSIONS These results confirm and extend on previous observations about the high frequency and heterogeneity of NF2 mutations in sporadic meningiomas and indicate they could be restricted to a well-defined cytogenetic and clinical subgroup of menopausal women. Further studies in large series of patients are required to confirm our observations.
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Santos MV, Furlanetti L, Valera ET, Brassesco MS, Tone LG, de Oliveira RS. Pediatric meningiomas: a single-center experience with 15 consecutive cases and review of the literature. Childs Nerv Syst 2012; 28:1887-96. [PMID: 22669518 DOI: 10.1007/s00381-012-1823-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 05/23/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The goal of this study was to determine the epidemiology, clinical presentation, associated factors, pathological features, and treatment outcome of pediatric meningiomas in a single-center institution. METHODS Clinical data of 15 patients under 18 years of age operated on for meningiomas from January 1994 to December 2010 were reviewed. RESULTS The study group included nine males and six females (mean age of 13 years at surgery). The most common symptoms at presentation were headaches in 6 out of 15 (40 %), raised intracranial pressure in 3 out of 15 (20 %), and seizures in 3 out of 15 (20 %). Sole operated tumors were found in 12 out of 15 (80 %), whose location is as follows: parasagittal in 4 out of 12 (33.3 %), 2 in the convexity (16.6 %), 2 at the skull base (16.6 %), and 4 in other sites (33.3 %). Six children presented with radiation-induced (RT) meningiomas and five had evidence of neurofibromatosis type 2 (NF2). Three patients had multiple meningiomas (all of them had NF2). Simpson's grade I excision was achieved in 12 out of 15 (80 %). On histopathology, 11 out of 15 (73.3 %) were grade I and 4 out of 15 (26.6 %) were grade II (all of them atypical). Five tumors (33.3 %) recurred, four of which had RT or NF2. During the mean follow-up period of 5 years, 12 out of 15 (80 %) had a good outcome (GOS=5). CONCLUSIONS Childhood meningiomas are uncommon lesions with a slight male predominance. Absence of large series with long follow-up precludes any definite conclusions on the clinical course and outcome of these tumors. Associated factors (such as RT and NF2), location, and extent of excision appear to be more important than histopathological grade in predicting outcome.
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Affiliation(s)
- Marcelo Volpon Santos
- Division of Pediatric Neurosurgery of the Department of Surgery and Anatomy, University Hospital of Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, Brazil
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Brassesco MS, Valera ET, Neder L, Pezuk JA, Oliveira RS, Scrideli CA, Tone LG. Cytogenetic findings in pediatric radiation-induced atypical meningioma after treatment of medulloblastoma: case report and review of the literature. J Neurooncol 2012; 110:397-402. [DOI: 10.1007/s11060-012-0982-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 10/01/2012] [Indexed: 11/24/2022]
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35
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Elbabaa SK, Gokden M, Crawford JR, Kesari S, Saad AG. Radiation-associated meningiomas in children: clinical, pathological, and cytogenetic characteristics with a critical review of the literature. J Neurosurg Pediatr 2012; 10:281-90. [PMID: 22900483 DOI: 10.3171/2012.7.peds1251] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Radiation-associated meningiomas (RAMs) arise after treatment with radiation to the cranium and are recognized as clinically separate from sporadic meningiomas. Compared with their sporadic counterparts, RAMs are often aggressive or malignant, likely to be multiple, and have a high recurrence rate. However, limited information exists about the clinical, pathological, and cytogenetic features of RAMs in pediatric patients. The authors report the findings in 9 children with meningiomas following therapeutic radiation to the cranium. In addition, they performed a critical review of the English language literature on pediatric RAMs. METHODS Medical files were searched for patients who demonstrated meningiomas after a history of radiation to the brain. Only those patients in whom a meningioma occurred before the age of 18 years were included in this study. Clinical and demographic data along with the MIB-1 labeling index and cytogenetic studies were evaluated. RESULTS The patients consisted of 5 males and 4 females with a median age of 5 years (range 2-10 years) at radiation therapy. The latency period was a median of 10 years after radiation therapy (range 6-13 years). The MIB-1 labeling index was a median of 6.6% (range 4%-10%). Five patients (55.6%) displayed multiple meningiomas at the first presentation. Histological types included clear cell meningioma in 1 patient, fibroblastic meningioma in 2, chordoid meningioma in 2, meningothelial meningioma in 7 (atypical in 2 cases), xanthomatous meningioma in 1, and chordoid meningioma in 1. Cytogenetic studies showed that the loss of 22q12.2 was the most common abnormality (3 patients), followed by complex cytogenetic abnormalities (2 patients) and rearrangements between chromosomes 1 and 12 (1 patient) and a 1p deletion (1 patient). CONCLUSIONS In contrast to RAMs occurring in adults, those in pediatric patients show an increased incidence of multiplicity on first presentation and unusual histological variants, some of which are described here for the first time. There was no difference in the MIB-1 labeling index in children with RAMs as compared with that in children with non-RAMs.
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Affiliation(s)
- Samer K Elbabaa
- Departments of Neurosurgery, University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Little Rock, Arkansas 72202, USA
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Godlewski B, Drummond KJ, Kaye AH. Radiation-induced meningiomas after high-dose cranial irradiation. J Clin Neurosci 2012; 19:1627-35. [PMID: 22836037 DOI: 10.1016/j.jocn.2012.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 05/07/2012] [Indexed: 10/28/2022]
Abstract
Radiation-induced meningiomas (RIM) are known to occur after high and low dose cranial radiation therapy. Currently, RIM are the most common form of radiation-induced neoplasm reported. We present the largest series of RIM induced by high dose radiation reported thus far and review the literature. Radiation therapy was most commonly given for childhood malignancy. We compared our group of 26 patients with RIM with previously published reports of RIM, and also with 364 patients with spontaneous meningioma (SM) treated at The Royal Melbourne Hospital between 2007 and 2011 with regard to age, gender, and histopathology. In our group of patients with RIM, the mean age at presentation was 38.5 years, in comparison to 60.1 years for patients with SM. The female-to-male ratio was 1.88:1 in RIM compared to 2.37:1 for SM. Of the RIM, 86.5% were World Health Organization (WHO) grade I and 11.5% were grade II (atypical) meningiomas. There were no anaplastic or malignant RIM. Of the SM, 91.5% were WHO grade I, 7.1% WHO grade II, and 1.4% WHO grade III meningiomas. The characteristics of RIM induced by low dose radiation therapy have been well described. It is timely to consider RIM due to high dose radiation, which is now frequently employed in the management of various childhood and other malignancies.
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Affiliation(s)
- Bartosz Godlewski
- Department of Neurosurgery and Peripheral Nerves Surgery, WAM University Hospital in Lodz, Medical University in Lodz, 113 Zeromskiego Street, Lodz 90-549, Poland.
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Fatty acid synthase is a predictive marker for aggressiveness in meningiomas. J Neurooncol 2012; 109:399-404. [PMID: 22744755 DOI: 10.1007/s11060-012-0907-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022]
Abstract
Meningiomas are the most frequent intracranial tumors. Although most are benign WHO grade I tumors, grade II and III tumors are aggressive and survival is poor. Treatment options for grade II and III meningiomas are limited, and molecular targets are few. The re-programming of metabolic pathways including glycolysis, lipogenesis, and nucleotide synthesis is a hallmark of the physiological changes in cancer cells. Because fatty acid synthase (FAS), the enzyme responsible for the de-novo synthesis of fatty acids, has emerged as a potential therapeutic target for several cancers, we investigated its involvement in meningiomas. We subjected 92 paraffin-embedded samples from 57 patients with grade I, 18 with grade II and III, and six with radiation-induced tumors to immunohistochemical study of FAS. Whereas its expression was increased in grade II and III meningiomas (62.9 %) compared with grade I tumors (29.8 %) (chi-squared test: p < 0.001), FAS was expressed in grade I tumors with a high MIB-1 index and infiltration into surrounded tissues. All radiation-induced meningiomas expressed FAS and its expression was positively correlated with the MIB-1 index (p < 0.005). Our findings suggest that increased FAS expression reflects the aggressiveness of meningiomas and that it may be a novel therapeutic target for treatment of unresectable or malignant tumors.
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Johnson MD, O’Connell M, Iqbal MA, Williams JP. Radiation effects on human leptomeningeal cell response to cerebrospinal fluid and PDGF-BB. Int J Radiat Biol 2012; 88:547-55. [DOI: 10.3109/09553002.2012.690929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
This article constitutes a mini-review of the pathology and genetics of meningiomas. Meningiomas are the most common primary intracranial tumors. They are usually durally based and are often found adjacent to venous sinuses and dural infoldings. The majority of these tumors are WHO grade I, although a minority is WHO grade II, atypical, or WHO grade III, anaplastic. Grade II and III meningiomas show a greater tendency than Grade I tumors to recur and metastasize. The current WHO scheme recognizes 15 histologic subtypes of meningiomas. Nine of these are WHO grade I, three are grade II, and three are grade III. In addition to these histologic subtypes, meningiomas can also be graded on the basis of mitotic activity, evidence of brain invasion, growth pattern cellular density, nuclear atypia, and necrosis. Loss of the long arm of chromosome 22, which is usually associated with inactivation of the NF2 gene, is the most common genetic abnormality found in meningiomas. Other chromosomal abnormalities associated with tumorogenesis and increased gradeof meningiomas include loss of heterozygosity for chromosome 1p, loss of 14q, deletion of 9p21, abnormalities of chromosome 10 and 17q. Telomerase activity increases with meningiomas grade as well. The only proven environmental risk factor for meningiomas is ionizing radiation. Radiation-induced meningiomas are more often multiple and have higher recurrence rates than standard meningiomas.
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Affiliation(s)
- Hussein Alahmadi
- Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada
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ODA K, SATO T, WATANABE T, ICHIKAWA M, ITO E, MATSUMOTO Y, ANDO H, SAKUMA J, KIKUTA A, HOJO H, SAITO K. Radiation-Induced World Health Organization Grade II Meningiomas in Young Patients Following Prophylactic Cranial Irradiation for Acute Lymphoblastic Leukemia in Childhood. Neurol Med Chir (Tokyo) 2012; 52:224-8. [DOI: 10.2176/nmc.52.224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Keiko ODA
- Department of Neurosurgery, Fukushima Medical University
| | - Taku SATO
- Department of Neurosurgery, Fukushima Medical University
| | | | | | - Eiji ITO
- Department of Neurosurgery, Fukushima Medical University
| | - Yuka MATSUMOTO
- Department of Neurosurgery, Fukushima Medical University
| | - Hitoshi ANDO
- Department of Neurosurgery, Fukushima Medical University
| | - Jun SAKUMA
- Department of Neurosurgery, Fukushima Medical University
| | | | - Hiroshi HOJO
- Department of Diagnostic Pathology, Fukushima Medical University
| | - Kiyoshi SAITO
- Department of Neurosurgery, Fukushima Medical University
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Bie L, Zhao G, Ju Y, Zhang B. Integrative genomic analysis identifies CCNB1 and CDC2 as candidate genes associated with meningioma recurrence. Cancer Genet 2011; 204:536-40. [DOI: 10.1016/j.cancergen.2011.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 07/28/2011] [Accepted: 08/11/2011] [Indexed: 11/15/2022]
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Jagannathan J, Oskouian RJ, Yeoh HK, Saulle D, Dumont AS. Molecular biology of unreresectable meningiomas: implications for new treatments and review of the literature. Skull Base 2011; 18:173-87. [PMID: 18978964 DOI: 10.1055/s-2007-1003925] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Even though meningiomas are most often benign tumors, they can be locally invasive and can develop in locations that prevent surgical treatment. The molecular and biologic factors underlying meningioma development are only now beginning to be understood. Genetic factors such as mutations in the neurofibromatosis-2 gene and in chromosomes 1, 9, and 10 play important roles in meningioma development and may be responsible for atypical tumors in some cases. Cellular factors such as telomerase activation and tyrosine kinase receptor mutations may also play an important role. Finally, autocrine and paracrine factors including epidermal growth factor receptor, platelet-derived growth factor-1, and fibroblast growth factor have been implicated in the development of some tumors. Although the relationship between the various factors implicated in tumor development is unknown, understanding these factors will be critical in the treatment of malignant or surgically inaccessible tumors.
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Affiliation(s)
- Jay Jagannathan
- Department of Neurosurgery, University of Virginia Health Sciences Center, Charlottesville, Virginia
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Alexiou GA, Moschovi M, Georgoulis G, Neroutsou R, Stefanaki K, Sfakianos G, Prodromou N. Anaplastic oligodendrogliomas after treatment of acute lymphoblastic leukemia in children: report of 2 cases. J Neurosurg Pediatr 2010; 5:179-83. [PMID: 20121367 DOI: 10.3171/2009.9.peds09154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Radiation-induced brain tumors are suggested to be the late complication of acute lymphoblastic leukemia (ALL) treatment. High-grade gliomas, meningiomas, and sarcomas are the most frequent neoplasms. Secondary anaplastic oligodendrogliomas are exceedingly rare. Five cases of pure anaplastic oligodendroglioma have been reported in the literature, and only 1 case was in a child after ALL treatment. The authors present 2 cases of pediatric anaplastic oligodendroglioma after treatment of ALL. Furthermore, they performed a molecular cytogenetic study and found loss of 1p in both cases. The authors provide a review of the previous cases and discuss their findings.
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Affiliation(s)
- George A Alexiou
- Department of Neurosurgery, University of Athens, Athens, Greece.
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Coexistence of cerebral aneurysm and meningioma—Pure accident? Clin Neurol Neurosurg 2009; 111:647-54. [DOI: 10.1016/j.clineuro.2009.05.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Revised: 05/28/2009] [Accepted: 05/29/2009] [Indexed: 12/11/2022]
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Brassesco MS, Valera ET, Neder L, Castro-Gamero AM, de Oliveira FM, Santos AC, Scrideli CA, Oliveira RS, Machado HR, Tone LG. Childhood radiation-associated atypical meningioma with novel complex rearrangements involving chromosomes 1 and 12. Neuropathology 2009; 29:585-90. [PMID: 19077038 DOI: 10.1111/j.1440-1789.2008.00991.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
MESH Headings
- Adolescent
- Brain Neoplasms/drug therapy
- Brain Neoplasms/genetics
- Brain Neoplasms/pathology
- Brain Neoplasms/radiotherapy
- Chromosome Aberrations
- Chromosomes, Human, Pair 1/genetics
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 6/genetics
- Combined Modality Therapy
- Comparative Genomic Hybridization
- Humans
- In Situ Hybridization, Fluorescence
- Magnetic Resonance Imaging
- Male
- Medulloblastoma/drug therapy
- Medulloblastoma/pathology
- Medulloblastoma/radiotherapy
- Meningioma/genetics
- Meningioma/pathology
- Neoplasms, Radiation-Induced/genetics
- Neoplasms, Radiation-Induced/pathology
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
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Affiliation(s)
- María Sol Brassesco
- Division of Pediatric Oncology, Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil.
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Kondziolka D, Kano H, Kanaan H, Madhok R, Mathieu D, Flickinger JC, Lunsford LD. STEREOTACTIC RADIOSURGERY FOR RADIATION-INDUCED MENINGIOMAS. Neurosurgery 2009; 64:463-9; discussion 469-70. [DOI: 10.1227/01.neu.0000336765.85922.d9] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE
Radiation-induced meningiomas of the brain are typically managed with surgical resection. Stereotactic radiosurgery (SRS) has become an important primary or adjuvant management for patients with intracranial meningiomas, but the value of this approach for radiation-induced tumors is unclear.
METHODS
This series consisted of 19 patients (mean age, 40 years) with 24 tumors. The patients met criteria for a radiation-induced meningioma and underwent gamma knife radiosurgery. Seven patients had undergone a previous resection. The World Health Organization tumor grades for those with prior histology were Grade I (n = 5) and Grade II (n = 2). The median tumor volume was 4.4 cm3. Radiosurgery was performed using a median margin dose of 13 Gy.
RESULTS
Serial imaging was evaluated in all patients at a median follow-up of 44 months. The control rate was 75% after primary radiosurgery. Delayed resection after radiosurgery was performed in 5 patients (26%) at an average of 39 months. The median latency between radiation therapy for original disease and SRS for radiation-induced meningiomas was 29.7 years (range, 7.3–59.0 years). The overall survival after SRS was 94.1% and 80.7% at 3 and 5 years, respectively. No patient developed a subsequent radiation-induced tumor. The overall morbidity rate was 5.3% (1 optic neuropathy). Asymptomatic peritumoral imaging changes compatible with an adverse radiation effect developed in 1 patient.
CONCLUSION
SRS provides satisfactory control rates either after resection or as an alternative to resection. Its role is most valuable for patients whose tumors affect critical neurological regions and who are poor candidates for resection.
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Affiliation(s)
- Douglas Kondziolka
- Departments of Neurological Surgery and Radiation Oncology, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Hideyuki Kano
- Departments of Neurological Surgery and Radiation Oncology, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Hilal Kanaan
- Departments of Neurological Surgery and Radiation Oncology, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ricky Madhok
- Departments of Neurological Surgery and Radiation Oncology, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David Mathieu
- Departments of Neurological Surgery and Radiation Oncology, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John C. Flickinger
- Departments of Neurological Surgery and Radiation Oncology, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - L. Dade Lunsford
- Departments of Neurological Surgery and Radiation Oncology, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
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Lillehei KO, Donson AM, Kleinschmidt-DeMasters BK. Radiation-induced meningiomas: clinical, cytogenetic, and microarray features. Acta Neuropathol 2008; 116:289-301. [PMID: 18604545 DOI: 10.1007/s00401-008-0401-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Revised: 06/03/2008] [Accepted: 06/04/2008] [Indexed: 10/21/2022]
Abstract
Limited information exists about the clinical and biological features of radiation-induced meningiomas (RIMs), particularly those that follow high-dose therapeutic radiation. We report our experience with 20 patients with RIMs (16 following high-dose radiotherapy) treated at our institution from 1993-2006. Patients (14 female, 6 male) had intervals from first radiotherapy to RIM diagnosis of 11-63 years; 12 had at least one RIM occur at an interval of 30 years or more after initial radiotherapy. Multiple RIMs were seen in six patients, with one patient developing his six RIMs sequentially over a 22-year interval. Most RIMs could be managed surgically, either with a single extensive resection or additional resection(s). Adjuvant stereotactic radiosurgery, external beam radiation, or chemotherapy were required in a minority (n = 6). Most were WHO grade I meningiomas. Complex karyotypes were found in three of four cases and abnormalities of chromosome 1p and/or LOH 1p36 were identified in five of 11 informative cases. Gene-expression microarray analysis of RIMs (n = 5) compared to non-RIMs (MEN, n = 6) and a panel of other tumors (n = 62) showed that RIM gene-expression was similar to that seen in MEN, and by clustering analysis did not separate from them. However, microarray comparative gene-expression analysis did demonstrate a few genes with significant differences in the expression level in RIM versus MEN. Of note, NF2 was under-expressed in four of five RIMs (P = 0.0065), at a similar level as measured in MEN.
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Ammerlaan ACJ, Houben MPWA, Tijssen CC, Wesseling P, Hulsebos TJM. Secondary meningioma in a long-term survivor of atypical teratoid/rhabdoid tumour with a germline INI1 mutation. Childs Nerv Syst 2008; 24:855-7. [PMID: 18236049 PMCID: PMC2413122 DOI: 10.1007/s00381-007-0578-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Indexed: 12/24/2022]
Abstract
OBJECTIVE We report on a patient who developed a meningioma more than two decades after removal at a young age of an atypical teratoid/rhabdoid tumour (AT/RT), which was due to a germline INI1 mutation, and radio- and chemotherapy. MATERIALS AND METHODS We present genetic evidence that the meningioma is not a recurrence or metastasis of the AT/RT and not due to the INI1 mutation, but is a radiation-induced tumour. CONCLUSION This is the first case illustrating that improved survival of young patients with an AT/RT after aggressive treatment may be gained at the cost of an increased risk for the development of radiation-induced, non-INI1-related tumours.
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Affiliation(s)
- A. C. J. Ammerlaan
- Department of Neurogenetics, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - M. P. W. A. Houben
- Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands
| | - C. C. Tijssen
- Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands
| | - P. Wesseling
- Department of Pathology, Nijmegen Center for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - T. J. M. Hulsebos
- Department of Neurogenetics, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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Sasayama T, Nishihara M, Tanaka K, Mizukawa K, Ehara K, Kanomata N, Kohmura E. Two metachronous tumors induced by radiation therapy: case report and review of the literature. J Neurooncol 2008; 88:315-20. [PMID: 18373066 DOI: 10.1007/s11060-008-9570-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Accepted: 03/17/2008] [Indexed: 10/22/2022]
Abstract
Various radiation-induced tumors, including meningioma, glioma, and sarcoma, have been reported; however, metachronous intracranial double tumors induced by radiation therapy are extremely rare. A 1-year-old boy had undergone tumor removal and craniospinal radiation therapy (30 Gy) for cerebellar medulloblastoma. At 24 years old, parasagittal meningioma developed in the left parietal region and was totally removed. Six years later, an infiltrative tumor was newly found in the right fronto-temporal white matter. The patient underwent stereotactic biopsy, and the tumor was found to be an anaplastic astrocytoma. Chromosomal analysis by fluorescence in situ hybridization (FISH) revealed loss of heterozygosity (LOH) of 1p. As the patient had previously had craniospinal irradiation, no additional radiation therapy was delivered. He underwent chemotherapy with temozolomide and the disease is now stable. Since both secondary tumors were located within the area of previous radiation and the patient did not have any genetic disease predisposing him to tumors, radiation therapy was considered to be responsible for their tumorigenesis. To our knowledge, this case is the fourth case of radiation-induced double CNS tumors arising after radiotherapy to be described in the literature. Whenever radiation is administered to children or young adults, careful serial screening studies are needed.
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Affiliation(s)
- Takashi Sasayama
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Japan.
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