Radiation-induced Intracerebral Cavernous Angiomas in Children with Malignant Brain Tumors : A Report of Two Cases

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  • 小児悪性脳腫瘍放射線治療後の血管腫発生 : 2症例の報告

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Cavernous angiomas forming in the brain after radiation therapy for pediatric brain tumors have recently attracted special interest as a late complication of radiation therapy. We report here on two children with malignant brain tumors who developed intracerebral cavernous angiomas 4 to 5 years after radiation therapy. A 14-year-old girl with a primitive neuroectodermal tumor developed a cavernous angioma in the hypothalamus after being irradiated with 55Gy 4 years ago. The second case, 13-year-old boy with a pineal mixed germ cell tumor showed a cavernous angioma at the thalamus 5 years after receiving radiation therapy with a dose of 60Gy. Both patients did not show any abnormal symptoms and the cavernous angiomas diagnoses were made with MRI findings. A review of 20 reported cases of radiation-induced cavernous angiomas in the brain revealed some characteristic findings: 1) Eighteen of the 20 cases were children, 2) Fourteen cases developed hemorrhage, 3) The radiation dose administered was distributed between 18-60Gy (median does of 43.5Gy), and 4) The median latent period was 7.5 years (range: 2-21 years). As a differential diagnosis for the recurrent tumor is guite difficult in most cases, it is necessary to observe patients who developed angioma-like lesions in the irradiated area carefully. (Received July 26, 2001; accepted December 4, 2001)

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