Raheja Amol, Satyarthee Guru Dutta
Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India.
Asian J Neurosurg. 2017 Jul-Sep;12(3):358-361. doi: 10.4103/1793-5482.180946.
Radiation therapy is widely used as adjuvant or primary treatment modality of neoplastic lesions. Radiation therapy may cause an acute adverse effect such as brain edema, radiation necrosis, or delayed, for example, panhypopituitarism, vasculitis, and rare neoplasm development. However, radiation-induced meningioma (RIM) occurrence is extremely rare. A detailed PubMed and Medline search yielded only three isolated Case-reports of RIM development in craniopharyngioma cases receiving radiotherapy after surgery. All cases occurred in patients < 13-year age, with male preponderance, detected after a mean interval of 23-year, the range being 2-44 years. Two had solitary while the third had multiple meningiomas. Authors report an 8-year-old female, who was operated for craniopharyngioma and received adjuvant therapy, was asymptomatic for next 30 years, met a road traffic accident and magnetic resonance imaging brain revealed incidental right sphenoid wing en plaque meningioma. She was planned for gamma-knife therapy as unwilling for surgical intervention. Management of RIM development after radiotherapy of craniopharyngioma along with pertinent literature is reviewed briefly.
放射治疗被广泛用作肿瘤性病变的辅助或主要治疗方式。放射治疗可能会引起急性不良反应,如脑水肿、放射性坏死,或延迟出现的不良反应,例如全垂体功能减退、血管炎以及罕见的肿瘤发生。然而,放射诱发的脑膜瘤(RIM)的发生极为罕见。通过对PubMed和Medline进行详细检索,仅发现了3例关于接受手术后放疗的颅咽管瘤病例发生RIM的孤立病例报告。所有病例均发生在13岁以下的患者中,男性居多,平均间隔23年(范围为2至44年)后被发现。其中2例为单发脑膜瘤,第3例为多发脑膜瘤。作者报告了一名8岁女性,因颅咽管瘤接受手术并接受辅助治疗,在接下来的30年里无症状,遭遇道路交通事故后,脑部磁共振成像偶然发现右侧蝶骨嵴平板状脑膜瘤。由于她不愿意接受手术干预,因此计划进行伽玛刀治疗。本文简要回顾了颅咽管瘤放疗后发生RIM的处理方法及相关文献。