title: De novo formation of brain tumors in pediatric population following therapeutic cranial irradiation.
abstract: OBJECTIVE
  Tumors of central nervous system (CNS) are accounted as the second most common tumors in childhood (21% of all cancers) following hematologic malignancies. The patients can suffer more than one cancer in their lifetime, and radiotherapy is claimed for de novo formation of a new tumor in years after treatment of an initial tumor.
  
  
  METHODS
  We have retrospectively analyzed our database for defining radiotherapy-related de novo brain tumors operated in between January, 2000 and August, 2012. New tumors in the field of radiotherapy were included into the study.
  
  
  RESULTS
  The retrospective analysis revealed six patients (two girls and four boys) eligible for further evaluation. The children were irradiated at an age in the range of 5 and 12 years (mean, 7.8). The primary diagnoses were hematological malignancies in two (acute lymphocytic leukemia and non-Hodgkin lymphoma (NHL)) and solid tumors in other four (two pilocytic astrocytoma, one craniopharyngioma, and one grade 3 astrocytoma). All patients received cranial radiotherapy. The mean latency period for the "second tumor" was 9.5 years. The pathological diagnoses for de novo new tumors were as follows: glial tumor (two cases), medulloblastoma (two cases), mesenchymal tumor (one case), and meningeal sarcoma (one case). All de novo tumors were high graded. Mean survival was 14.6 months.
  
  
  CONCLUSIONS
  de novo brain tumors after irradiation has poor prognosis in neurosurgical practice. Vigilance and awareness for possibility of de novo new tumor are warranted for both families and physicians at follow-ups even years after the treatment of initial tumors.
authors.affiliation: Department of Neurosurgery, Hacettepe University School of Medicine, Sıhhıye, Ankara, Turkey, burcak@tr.net.
authors.forename: Burcak
authors.initials: B
authors.lastname: Bilginer
authors.forename: Cezmi Cagrı
authors.initials: CC
authors.lastname: Türk
authors.forename: Fırat
authors.initials: F
authors.lastname: Narin
authors.forename: Burcu
authors.initials: B
authors.lastname: Hazer
authors.forename: Sahin
authors.initials: S
authors.lastname: Hanalioglu
authors.forename: Kader Karlı
authors.initials: KK
authors.lastname: Oguz
authors.forename: Figen
authors.initials: F
authors.lastname: Soylemezoglu
authors.forename: Nejat
authors.initials: N
authors.lastname: Akalan
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D006402:Hematologic Diseases / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000209:etiology*; D012189:Retrospective Studies; D055815:Young Adult
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