[Intracranial fibrosarcoma fifteen years after radiotherapy in bilateral retinoblastomas: effect of combined chemotherapy with cisplatin and VP-16].
We report intracranial fibrosarcoma which developed after radiotherapy for bilateral retinoblastomas. A 16-year-old boy was admitted with swelling of his left eyelid as his chief complaint on September 10, 1987. He had a past history of bilateral retinoblastomas at one year of age, which was treated by bilateral ophthalmectomy and postoperative radiotherapy; 50 Gy to right eye and 60 Gy to left eye. Until fifteen years old, he had no trouble except blindness. On admission, a dumb-bell type huge tumor with the destruction of the orbital roof was demonstrated on CT scan and MRI. The tumor was composed of solid orbital tumor and cystic tumor located in the left frontal lobe. On September 18, partial removal of the orbital tumor and evacuation of the intracranial cyst following embolization of the left external carotid artery was performed. The histological diagnosis of the tumor was fibrosarcoma. For the residual tumor, combined radiochemotherapy was carried out. The patient was treated with intravenous administration of 20 mg/m2 of cisplatin and 60 mg/m2 of VP-16 daily for five days and then whole brain radiotherapy of 26 Gy. On March 27, 1988, he obtained a complete remission of the tumor and was discharged without neurological deficit except blindness. In this case, we have presented a radiation-induced secondary tumor after a treatment of bilateral retinoblastomas. Although the tumor was highly proliferative and invasive fibrosarcoma, we could control it well by multimodality treatment including surgery, radiation and chemotherapy. It is noteworthy that combined chemotherapy with cisplatin and VP-16 was effective against this type of tumor.
Mizuno
M
M
Department of Neurosurgery, Nagoya University School of Medicine.
Yoshida
J
J
Shimosawa
S
S
Kuchiwaki
H
H
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D005134:Eye Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005354:Fibrosarcoma / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D005625:Frontal Lobe; D006801:Humans; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D009918:Orbital Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011878:Radiotherapy / Q000009:adverse effects*; D012175:Retinoblastoma / Q000532:radiotherapy* / Q000601:surgery
D005047:Etoposide; D002945:Cisplatin