J Korean Neurosurg Soc.  2014 Jan;55(1):54-56. 10.3340/jkns.2014.55.1.54.

Should Adjuvant Radiotherapy Be Recommended for Pediatric Craniopharyngiomas?

• Dadlani R
• Ghosal N
• Hegde AS

• KMID: 2191043
• DOI: http://doi.org/10.3340/jkns.2014.55.1.54

Abstract

Intracranial tumors secondary to radiotherapy are rare. In this group gliomas are the rarest. Only 6 cases of glioblastoma multiforme (GBM) have been reported in patients undergoing radiotherapy (RT) for craniopharyngiomas of which only 4 have been in children less than 18 years of age. In recent years RT has become a mainstay of adjuvant therapy for recurrent or partially excised craniopharyngiomas. We report a child of 12 years who had previously undergone RT for a suprasellar craniopharyngioma and presented 10 years later with a GBM. This is the 5th pediatric case in literature demonstrating a GBM after RT for a craniopharyngioma. The implications of subjecting the pediatric population to RT for a benign lesion versus the outcome of gross total removal and management of RT induced tumors is discussed and the need to avail of safer alternatives such as stereotactic radiosurgery is stressed.

Keyword

Craniopharyngioma; Radiotherapy; Glioblastoma; Pediatric

MeSH Terms

Child
Craniopharyngioma*
Glioblastoma
Glioma
Humans
Radiosurgery
Radiotherapy
Radiotherapy, Adjuvant*

Figure

• 

  Fig. 1 A and B : Images demonstrating the craniopharyngioma at recurrence. These were the earliest CT images available. C and D : Images demonstrate the lesion with hydrocephalus when the patient had presented to our institute for the first time. E and F : Images are T1 weighted MRI images demonstrating the right temporal GBM. There is peripheral contrast enhancement with central necrosis. Mass effect and midline shift is demonstrated. G and H : Images are post operative MRI images delineating the tumor cavity with near complete excision.

• 

  Fig. 2 Paraffin section of glioblastoma multiforme showing. Cellular and nuclear pleomorphism with tumor giant cells (A), hemorrhagic necrosis and (inset) frequent mitotic activity (curved arrows) (B). Immunopositivity for glial fibrillary acidic protein in tumor cells (C). Hematoxylin & Eosin ×400 (A); ×100 (B); ×400 (B, Inset). Avidin Biotin Complex Immunoperoxidase ×400 (C).

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