title: Malignancy in vestibular schwannoma after stereotactic radiotherapy: a case report and review of the literature.
abstract: OBJECTIVE
  A relation between conventional radiotherapy and the development of intracranial neoplasma is well known, but radiation-associated tumor following stereotactic radiotherapy of vestibular schwannoma is underestimated. In this article we will study this relation by doing a complete literature review on all the malignant intracranial tumors that appeared following radiosurgery and adding a case of malignant vestibular schwannoma following stereotactic radiotherapy in a Neurofibromatosis type 2 patient.
  
  
  METHODS
  Literature review and discussion.
  
  
  RESULTS
  We found 26 cases of malignant brain tumor following stereotactic radiotherapy including our case. In 13 cases the tumor occurred in context of Neurofibromatosis type 2. None of the patients had a tumor size less than 2.5 cm. and the mean latency period between the radiotherapy and malignant tumor development was 5.8 years.
  
  
  CONCLUSIONS
  Patients with vestibular schwannoma should be made aware of the low incidence of the radiation-induced malignant changes and long-term follow-up is mandatory.
authors.affiliation: Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Italy. drsam_t@yahoo.com
authors.forename: Sami
authors.initials: S
authors.lastname: Tanbouzi Husseini
authors.forename: Enrico
authors.initials: E
authors.lastname: Piccirillo
authors.forename: Abdelkader
authors.initials: A
authors.lastname: Taibah
authors.forename: Carlo T
authors.initials: CT
authors.lastname: Paties
authors.forename: Roberto
authors.initials: R
authors.lastname: Rizzoli
authors.forename: Mario
authors.initials: M
authors.lastname: Sanna
mesh_terms: D000293:Adolescent; D002471:Cell Transformation, Neoplastic; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009464:Neuroma, Acoustic / Q000473:pathology* / Q000601:surgery*; D016634:Radiosurgery / Q000009:adverse effects*