Glioblastoma multiforme as a secondary malignancy following stereotactic radiosurgery of a meningioma: case report

Neurosurg Focus. 2019 Jun 1;46(6):E11. doi: 10.3171/2019.3.FOCUS1948.

Abstract

The documentation and exact incidence of stereotactic radiosurgery (SRS)-induced neoplasia is not well understood, with most literature restricted to single case reports and single-center retrospective reviews. The authors present a rare case of radiosurgery-induced glioblastoma multiforme (GBM) following radiosurgical treatment of a meningioma. A 74-year-old patient with a sporadic meningioma underwent radiosurgery following surgical removal of a WHO grade II meningioma. Eighteen months later she presented with seizures, and MRI revealed an intraaxial tumor, which was resected and proven to be a glioblastoma. As far as the authors are aware, this case represents the third case of GBM following SRS for a meningioma. This report serves to increase the awareness of this possible complication following SRS. The possibility of this rare complication should be explained to patients when obtaining their consent for radiosurgery.

Keywords: GBM = glioblastoma multiforme; GK = Gamma Knife; MPNST = malignant peripheral nerve sheath tumor; NF2 = neurofibromatosis type 2; SRS = stereotactic radiosurgery; VS = vestibular schwannoma; glioblastoma; malignant transformation; meningioma; radiosurgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / etiology*
  • Brain Neoplasms / surgery
  • Cranial Irradiation / adverse effects*
  • Female
  • Genetic Predisposition to Disease
  • Glioblastoma / diagnostic imaging
  • Glioblastoma / etiology*
  • Glioblastoma / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / surgery*
  • Meningioma / diagnostic imaging
  • Meningioma / surgery*
  • Neoplasms, Radiation-Induced / diagnostic imaging
  • Neoplasms, Radiation-Induced / etiology*
  • Neoplasms, Radiation-Induced / surgery
  • Neoplasms, Second Primary / diagnostic imaging
  • Neoplasms, Second Primary / etiology*
  • Neoplasms, Second Primary / surgery
  • Neuroimaging
  • Radiosurgery / adverse effects*
  • Seizures / etiology