Abstract
The causal relationship between cranial irradiation and the subsequent development of meningioma is well established. However, very few studies have reported the development of a meningioma at the site of a previous craniotomy, even in cases where the patient underwent cranial irradiation after resection of a brain tumor. We report a case of meningioma that developed at the same site where a craniotomy was performed for the resection of an arteriovenous malformation (AVM) 9 years after radiotherapy.
The patient had been diagnosed with acute lymphoblastic lymphoma at the age of 2 years, for which he received chemotherapy followed by prophylactic cranial irradiation. At the age of 11 years, the patient was hospitalized because of an intracerebral hematoma caused by a ruptured AVM. He underwent an uneventful resection of the AVM, and an artificial dura capable of inducing granulomatous reaction as a foreign body was used. At the age of 22 years, he presented with right arm numbness. The magnetic resonance imaging (MRI) scan showed a large well-defined mass in the left parietal region, where an AVM had been resected previously. The tumor was completely removed, and pathological examination had revealed that the tumor was a meningothelial meningioma without malignant features. The postoperative course was uneventful, and MRI performed 1 year after surgery revealed no signs of recurrence. In addition to irradiation, extrinsic etiological factors such as surgical trauma and chronic inflammation might have led to the development of a meningioma at the same site of the previous craniotomy.
