title: Radiation-induced astrocytoma with rapid malignant transformation: case report.
abstract: A 23-year-old man was admitted with a rare case of radiation-induced astrocytoma manifesting as 3-month history of unstable gait. He had received 50 Gy of irradiation therapy for a germ cell tumor in the right basal ganglia 13 years earlier. Magnetic resonance (MR) imaging on admission showed a non-enhanced mass lesion in the right cerebellar hemisphere with expansion to the vermis. The histological diagnosis of the stereotaxic biopsy specimen was grade II astrocytoma. Two months later, he developed drowsiness, and MR imaging demonstrated that the tumor had enlarged and was enhanced after gadolinium injection. The clinical diagnosis was high-grade glioma resulting from malignant transformation. The tumor had compressed the mesencephalic aqueduct, leading to obstructive hydrocephalus. Endoscopic third ventriculostomy was performed to improve the cerebrospinal fluid circulation. He underwent chemotherapy with temozolomide postoperatively, but died 8 months after the initial diagnosis of astrocytoma. The clinical course of radiation-induced astrocytoma is not benign. The potential for malignant transformation necessitates careful postoperative follow up for patients with this tumor.
authors: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. fkomatsu@fukuoka-u.ac.jp
authors: Fuminari
authors: F
authors: Komatsu
authors: Hiroshi
authors: H
authors: Kawaguchi
authors: Hitoshi
authors: H
authors: Tsugu
authors: Shinya
authors: S
authors: Oshiro
authors: Mika
authors: M
authors: Komatsu
authors: Takeo
authors: T
authors: Fukushima
authors: Kazuki
authors: K
authors: Nabeshima
authors: Tooru
authors: T
authors: Inoue
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001254:Astrocytoma / Q000150:complications* / Q000188:drug therapy; D001479:Basal Ganglia / Q000473:pathology; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D002471:Cell Transformation, Neoplastic; D002528:Cerebellar Neoplasms / Q000150:complications* / Q000188:drug therapy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017809:Fatal Outcome; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000532:radiotherapy*; D009381:Neoplasms, Radiation-Induced / Q000150:complications* / Q000188:drug therapy; D016609:Neoplasms, Second Primary / Q000150:complications* / Q000188:drug therapy; D000077204:Temozolomide; D013997:Time Factors; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide