A Case of Synchronous Radiation-induced Glioblastoma and Meningioma diagnosed 41 Years after Radiation Therapy for Anaplastic Ependymoma

Abstract

  Radiation therapy to the head occasionally leads to radiation-induced brain tumors, but synchronous or metachronous radiation-induced brain tumors are very rare. Herein, we present a case of radiation-induced glioblastoma and meningioma that were synchronously diagnosed 41 years after radiation therapy. The patient was a 49-year-old man who was diagnosed with anaplastic ependymoma at the age of 8 years. He underwent tumor resection from the right frontal lobe, followed by extended focal radiation therapy. Pathological findings were consistent with anaplastic ependymoma. Forty-one years later, the patient was transferred to the hospital due to a seizure attack. Magnetic resonance imaging revealed an irregular contrast-enhanced tumor in the right frontal white matter and a well-enhanced mass attached to the dura of the right frontal convexity. He underwent tumor resection in distinct regions. The tumors were histopathologically diagnosed as glioblastoma and meningioma, respectively. The present case reveals the risk of radiation-induced benign and malignant brain tumors even after long period, which highlights the necessity of persistent follow-up.