Radiation-induced CNS tumor in children: a diagnostic challenge
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v4i2.5260
Abstract
Neuroradiology plays an important role in the diagnosis of CNS tumors, both in defining treatment and in short and long-term follow-up. Diffusion and its correlation with ADC is a modality that has recently become relevant to establish the degree of malignancy of certain tumors, such as CNS gliomas. Gliomas are the most frequent CNS tumors in pediatrics, constituting 47% of these. We present a clinical case of a pediatric patient diagnosed with posterior fossa medulloblastoma and a radiation-induced tumor (high-grade glioma), diagnosed four years after radiotherapy, which presented difficulties in neuroradiological diagnosis due to its unusual characteristics. It continues to be a challenge for current neuroradiology to be able to establish the etiology of CNS lesions in cancer patients before surgical treatment.
Keywords
central nervous system neoplasms; glioma; pediatrics; radiation-induced tumor
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[4] Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, et al. The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol. 2021;23:1231-51.
[5] Cohen AR. Brain tumors in children. N Engl J Med. 2022;386:1922-31.
[6] Ma L, Song ZJ. Differentiation between low-grade and high-grade glioma using combined diffusion tensor imaging metrics. Clin Neurol Neurosurg. 2013;115:2489-95.
[7] Chojnacka M, Pedziwiatr K, Skowronska-Gardas A, Perek-Polnik M, Perek D, Olasek P. Second brain tumors following central nervous system radiotherapy in childhood. Br J Radiol. 2014;87:20140211.
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[9] Packer RJ, Zhou T, Holmes E, Vezina G, Gajjar A. Survival and secondary tumors in children with medulloblastoma receiving radiotherapy and adjuvant chemotherapy: results of Children's Oncology Group trial A9961. Neuro Oncol. 2013;15:97-103.
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[12] Batra A, Tripathi RP. Atypical diffusion-weighted magnetic resonance findings in glioblastoma multiforme. Australas Radiol. 2004;48: 388-91.
[13] Kao HW, Chiang SW, Chung HW, Tsai FY, Chen CY. Advanced MR imaging of gliomas: an update. Biomed Res Int. 2013;2013:970586.
Copyright © 2026 Mariela C. Salerno, Raúl Ramos, Francisco Maldonado, Carlos Rugilo
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