1. Concurrent Pituicytoma, Meningioma, and Cavernomas After Cranial Irradiation for Childhood Acute Lymphoblastic Leukemia
- Author
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Aaron N. Chester, Chi Hau Tan, Andrew Parker, and Vanaja Muthurajah
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Central nervous system ,Hypopituitarism ,medicine.disease ,Radiation therapy ,Meningioma ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Cranial Irradiation ,hemic and lymphatic diseases ,030220 oncology & carcinogenesis ,medicine ,Surgery ,Neurology (clinical) ,Radiology ,Prophylactic cranial irradiation ,business ,Childhood Acute Lymphoblastic Leukemia ,030217 neurology & neurosurgery ,Pituicytoma - Abstract
Background The majority of patients with acute lymphoblastic leukaemia develop disease relapse in the central nervous system in the absence of central nervous system−directed prophylactic therapy. In the past, prophylactic cranial irradiation was commonly used in the form of whole-brain radiotherapy in patients with acute lymphoblastic leukemia to prevent the development of intracranial diseases. However, in addition to the inherent risk of toxicity, this type of therapy has several delayed side effects including the development of secondary intracranial tumors. Case Description We report a rare case of a patient with concurrent pituicytoma, meningioma, and cavernomas 44 years after prophylactic cranial irradiation for childhood acute lymphoblastic leukemia. The patient presented with visual disturbance, headache, and features of hypopituitarism. Endoscopic transsphenoidal resection of the pituicytoma and meningioma was performed. Subsequent regrowth of the residual meningioma necessitated further surgery and adjuvant treatment with radiotherapy. Conclusions This case report highlights the unusual case of a patient with 3 concurrent intracranial lesions of distinct pathologies after prophylactic cranial irradiation therapy for childhood acute lymphoblastic leukemia.
- Published
- 2020
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