Korean J Radiol.  2012 Oct;13(5):652-657. 10.3348/kjr.2012.13.5.652.

Spinal Cord Glioblastoma Induced by Radiation Therapy of Nasopharyngeal Rhabdomyosarcoma with MRI Findings: Case Report

• Ahn SJ
• Kim IO

• KMID: 1392947
• DOI: http://doi.org/10.3348/kjr.2012.13.5.652

Abstract

Radiation-induced spinal cord gliomas are extremely rare. Since the first case was reported in 1980, only six additional cases have been reported.; The radiation-induced gliomas were related to the treatment of Hodgkin's lymphoma, thyroid cancer, and medullomyoblastoma, and to multiple chest fluoroscopic examinations in pulmonary tuberculosis patient. We report a case of radiation-induced spinal cord glioblastoma developed in a 17-year-old girl after a 13-year latency period following radiotherapy for nasopharyngeal rhabdomyosarcoma. MRI findings of our case are described.

Keyword

Radiation induced glioma; Glioblastoma; Spinal cord; Rhabdomyosarcoma; Magnetic resonance imaging

MeSH Terms

Contrast Media/diagnostic use
Female
Gadolinium DTPA/diagnostic use
Glioblastoma/*diagnosis/pathology/surgery
Humans
*Magnetic Resonance Imaging
Nasopharyngeal Neoplasms/*radiotherapy
Neoplasms, Radiation-Induced/*diagnosis/pathology
Rhabdomyosarcoma/*radiotherapy
Spinal Cord Neoplasms/*diagnosis/pathology/surgery

Figure

• 

  Fig. 1 Magnetic resonance imaging and pathologic findings of radiation-induced spinal cord glioblastoma. A. Radiation field. Bidirectional right and left spinal ports were used and field of radiation coverage spanned zygomatic area to C6 level. Cervical spine MRI at symptom onset. B. Sagittal T2-weighted image shows diffuse enlargement and increased signal intensity of cervical cord from C2 to C4, which is accompanied with minimal edema. C. Sagittal T1-weighted image shows iso to hypo signal intensity compared to lesion. D, E. Contrast-enhanced sagittal (D) and axial (E) T1-weighted images show ring-like enhancement at periphery, nodular discrete enhancement at upper portion of lesion, and multiple stippled foci of enhancement. F. Cervical spine MRI on 11th postsurgical day: Residual mass has become more expanded, and longitudinal extent of abnormal high signal intensity increased on sagittal T2-weighted image. G. Photomicrography of glioblastoma shows neoplastic astrocytes with high cellularity, nuclear pleomorphism, and high frequency of atypical mitosis (H & E stain, magnifications × 200).

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