Coexistence of Radiation-Induced Meningioma and Moyamoya Syndrome 10 Years after Irradiation against Medulloblastoma: a Case Report.
10.3346/jkms.2017.32.11.1896
- Author:
Ji Yeon HAN
1
;
Jung Won CHOI
;
Kyu Chang WANG
;
Ji Hoon PHI
;
Ji Yeoun LEE
;
Jong Hee CHAE
;
Sung Hye PARK
;
Jung Eun CHEON
;
Seung Ki KIM
Author Information
1. Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Meningioma;
Moyamoya Syndrome;
Medulloblastoma;
Radiation-Induced Vasculopathy;
Radiation-Induced Tumor;
Radiotherapy
- MeSH:
Adolescent;
Aphasia;
Basal Ganglia;
Central Nervous System;
Cerebral Angiography;
Cerebral Infarction;
Child;
Deglutition Disorders;
Dizziness;
Drug Therapy;
Dysarthria;
Follow-Up Studies;
Frontal Lobe;
Headache;
Humans;
Magnetic Resonance Imaging;
Male;
Medulloblastoma*;
Meningioma*;
Moyamoya Disease*;
Radiotherapy
- From:Journal of Korean Medical Science
2017;32(11):1896-1902
- CountryRepublic of Korea
- Language:English
-
Abstract:
Radiotherapy is one of the standard treatments for medulloblastoma. However, therapeutic central nervous system irradiation in children may carry delayed side effects, such as radiation-induced tumor and vasculopathy. Here, we report the first case of coexisting meningioma and moyamoya syndrome, presenting 10 years after radiotherapy for medulloblastoma. A 13-year-old boy presented with an enhancing mass at the cerebral falx on magnetic resonance imaging (MRI) after surgery, radiotherapy (30.6 Gy craniospinal axis, 19.8 Gy posterior fossa) and chemotherapy against medulloblastoma 10 years ago, previously. The second tumor was meningioma. On postoperative day 5, he complained of right-sided motor weakness, motor dysphasia, dysarthria, and dysphagia. MRI revealed acute cerebral infarction in the left frontal lobe and both basal ganglia. MR and cerebral angiography confirmed underlying moyamoya syndrome. Four months after the meningioma surgery, the patient presented with headaches, dysarthria, and dizziness. Indirect bypass surgery was performed. He has been free from headaches since one month after the surgery. For patients who received radiotherapy for medulloblastoma at a young age, clinicians should consider the possibility of the coexistence of several complications. Careful follow up for development of secondary tumor and delayed vasculopathy is required.
