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Secondary Glioblastoma Multiforme in a Child with Disseminated Juvenile Pilocytic Astrocytoma

机译:继发性胶质母细胞瘤多发性儿童少年星形胶质细胞瘤。

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摘要

Secondary glioblastoma multiforme (sGBM) can occur after a long latency period following radiation treatment of various diseases including brain tumors, leukemia, and more benign disorders like tinea capitis. Outcomes of radiation-induced sGBM remain poor in both children and adults. We report a case of a 16-year-old girl with a history of disseminated juvenile pilocytic astrocytoma treated with chemotherapy and craniospinal radiation 9 years prior who developed sGBM in the absence of a tumor predisposition syndrome. She presented with a several-week history of headaches and no acute findings on computed tomography compared to baseline neuroimaging 3 months prior. Repeat computed tomography performed just 3 weeks later for worsening headaches revealed a new large posterior fossa tumor where pathology confirmed the diagnosis of sGBM. In spite of maximal surgical resection, reirradiation, and adjuvant chemotherapy, she died 1 year postdiagnosis. Our case highlights the potential late effects of high-dose cranial radiation, how symptomatology may precede neuroimaging findings, and the rapid formation of sGBM that mirrors that of de novo Glioblastoma Multiforme.
机译:继发性胶质母细胞瘤(sGBM)可能会在放疗各种疾病(包括脑瘤,白血病和更多的良性疾病,例如头癣)后经过很长的潜伏期后发生。在儿童和成人中,辐射诱发的sGBM的结果仍然很差。我们报告了一个病例,该病例有一个16岁的女孩,在有肿瘤易感综合征的情况下发展了sGBM,9年前曾用化学疗法和颅脊髓放射治疗过弥散性幼小毛细胞星形细胞瘤。与3个月前的基线神经影像学检查相比,她表现出了头痛的几周病史,并且在计算机断层扫描上没有出现急性发现。由于头痛加剧,仅在3周后进行了重复计算机断层扫描,发现了新的大后颅窝肿瘤,病理证实了sGBM的诊断。尽管进行了最大程度的外科手术切除,再照射和辅助化疗,但她在诊断后1年死亡。我们的病例强调了高剂量颅脑放射的潜在后期影响,神经影像学发现之前的症状学可能以及与新生胶质母细胞瘤相似的sGBM的快速形成。

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