title: Meningioma after radiotherapy for malignancy.
abstract: Complications of radiation exposure have gained importance with increasing cancer survivorship. Secondary malignancies have been associated with cranial radiation exposure. We present our experience with intracranial radiation-induced meningioma (RIM) and discuss the implications of its presentation and natural history for patient management. Patients diagnosed with meningioma who had received radiation therapy between 1960 and 2014 were identified. Records were retrospectively reviewed for details of radiation exposure, previous malignancies, meningioma subtypes, multiplicity and pathologic descriptions, treatment and follow-up. Thirty patients were diagnosed with RIM. Initial malignancies included acute lymphocytic leukemia (33.3%), medulloblastoma (26.7%) and glioma (16.7%) at a mean age of 8.1years (range 0.04-33years). The mean radiation dose was 34Gy (range 16-60Gy) and latency time to meningioma was 26years (range 8-51years). Twenty-one patients (70%) underwent surgery. Of these, 57.1% of tumors were World Health Organization (WHO) grade I while 42.9% were WHO II (atypical). The mean MIB-1 labeling index for patients with WHO I tumors was 5.44%, with 33.3% exhibiting at least 5% staining. Mean follow-up after meningioma diagnosis was 5.8years. Mortality was zero during the follow-up period. Meningioma is an important long-term complication of therapeutic radiation. While more aggressive pathology occurs more frequently in RIM than in sporadic meningioma, it remains unclear whether this translates into an effect on survival. Further study should be aimed at delineating the risks and benefits of routine surveillance for the development of secondary neoplasms after radiation therapy.
authors.affiliation: Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA. Electronic address: pfmorgenstern@gmail.com.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Morgenstern
authors.affiliation: Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Kalee
authors.initials: K
authors.lastname: Shah
authors.affiliation: Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Ira J
authors.initials: IJ
authors.lastname: Dunkel
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Anne S
authors.initials: AS
authors.lastname: Reiner
authors.affiliation: Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA; Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Khakoo
authors.affiliation: Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Marc K
authors.initials: MK
authors.lastname: Rosenblum
authors.affiliation: Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Gutin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008577:Meningeal Neoplasms / Q000209:etiology / Q000473:pathology*; D008579:Meningioma / Q000209:etiology / Q000473:pathology*; D009381:Neoplasms, Radiation-Induced / Q000473:pathology*; D055815:Young Adult
keywords: Meningioma; Radiation induced meningioma; Radiation therapy