Intracranial malignancies occurring more than 20 years after radiation therapy for pituitary adenoma.
A 37-year-old woman developed a left third cranial nerve palsy 28 years after radiation for a nonsecreting pituitary adenoma. Imaging disclosed a left parasellar mass and a midbrain/pontine signal abnormality. Biopsy of the parasellar mass revealed a malignant sarcoma. The brainstem abnormality was presumptively diagnosed as a malignant glioma. A 63-year-old man developed a malignant astrocytoma of the left optic nerve and chiasm 23 years after partial excision and radiation of a nonsecreting pituitary adenoma. Both patients died of their malignancies. Although secondary malignancies have been described in this setting, such long latencies have not been reported.
Wu-Chen
Wen Ying
WY
Department of Neurology, Temple University Hospital, Philadelphia, Pennsylvania, USA.
Jacobs
Dina A
DA
Volpe
Nicholas J
NJ
Dalmau
Joseph O
JO
Moster
Mark L
ML
D000236:Adenoma / Q000532:radiotherapy*; D000328:Adult; D020295:Brain Stem Neoplasms / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D005910:Glioma / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D019574:Optic Nerve Neoplasms / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D010911:Pituitary Neoplasms / Q000532:radiotherapy*; D013997:Time Factors