title: Rates and characteristics of radiographically detected intracerebral cavernous malformations after cranial radiation therapy in pediatric cancer patients.
abstract: Rates and characteristics of intracerebral cavernous malformations after cranial radiation therapy remain poorly understood. Herein we report on intracerebral cavernous malformations detected on follow-up imaging in pediatric cancer patients who received cranial radiation therapy at age ≤18 years from 1980 to 2009. Through chart reviews (n = 362) and phone interviews (n = 104) of a retrospective cohort, we identified 10 patients with intracerebral cavernous malformations. The median latency time for detection of intracerebral cavernous malformations after cranial radiation therapy was 12 years (range 1-24 years) at a median age of 21.4 years (interquartile range = 15-28). The cumulative incidence was 3% (95% confidence interval 1%-8%) at 10 years post cranial radiation therapy and 14% (95% confidence interval 7%-26%) at 15 years. Three patients underwent surgical resection. Two surgical specimens were pathologically similar to sporadically occurring intracerebral cavernous malformations; one was consistent with capillary telangiectasia. Intracerebral cavernous malformations are common after cranial radiation therapy and can show a spectrum of histologic features.
authors.affiliation: Department of Pediatrics, University of California, San Francisco - Fresno.
authors.forename: Erica
authors.initials: E
authors.lastname: Gastelum
authors.affiliation: Department of Neurology, University of California, San Francisco.
authors.forename: Katherine
authors.initials: K
authors.lastname: Sear
authors.affiliation: Department of Neurology, University of California, San Francisco.|Epidemiology& Biostatistics, University of California, San Francisco.
authors.forename: Nancy
authors.initials: N
authors.lastname: Hills
authors.affiliation: Department of Neurology, University of California, San Francisco.
authors.forename: Erika
authors.initials: E
authors.lastname: Roddy
authors.affiliation: Department of Neurology, University of California, San Francisco.
authors.forename: Dominica
authors.initials: D
authors.lastname: Randazzo
authors.affiliation: Department of Neurology, University of California, San Francisco.
authors.forename: Nassim
authors.initials: N
authors.lastname: Chettout
authors.affiliation: Radiology, University of California, San Francisco.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hess
authors.affiliation: Pathology, University of California, San Francisco.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cotter
authors.affiliation: Pediatrics, University of California, San Francisco.|Radiation Oncology, University of California, San Francisco.
authors.forename: Daphne A
authors.initials: DA
authors.lastname: Haas-Kogan
authors.affiliation: Department of Neurology, University of California, San Francisco.|Pediatrics, University of California, San Francisco.
authors.forename: Heather
authors.initials: H
authors.lastname: Fullerton
authors.affiliation: Department of Neurology, University of California, San Francisco.|Pediatrics, University of California, San Francisco.|Neurosurgery, University of California, San Francisco.
authors.forename: Sabine
authors.initials: S
authors.lastname: Mueller
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000528:radiation effects; D001932:Brain Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D020786:Hemangioma, Cavernous, Central Nervous System / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: cranial radiation therapy; intracerebral cavernous malformation; pediatric cancer survivors