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Case Reports
. 2016 Feb 29;4(4):356-60.
doi: 10.1002/ccr3.521. eCollection 2016 Apr.

A case of multiple radiation-induced gliomas 24 years after radiation therapy against pituitary adenoma

Akihito Kato  1 , Goro Nagashima  2
Affiliations
Case Reports

A case of multiple radiation-induced gliomas 24 years after radiation therapy against pituitary adenoma

Akihito Kato et al. Clin Case Rep. .

Abstract

We treated a case in which multiple astrocytomas of varying grades developed in the irradiation field 24 years after radiation therapy. Differentiation from radiation necrosis based on presurgical diagnostic imaging was difficult; therefore, we feel it is essential to aggressively pursue histological diagnoses to select the optimal treatment method.

Keywords: autopsy; multiple radiation‐induced gliomas; pituitary adenoma; temozolomide.

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Figures

Figure 1
Figure 1
Preirradiation CT (A) and the irradiation field (B).
Figure 2
Figure 2
The brainstem was the contrast in MRI (A), FDG‐PET showed abnormal uptake (B), TI‐SPECT showed signs of uptake in the early phase (C), and MR spectroscopy showed no signs of lactate or lipid increases (D).
Figure 3
Figure 3
The left medial temporal lobe was the contrast in MRI (A), FDG‐PET showed no abnormal uptake (B), TI‐SPECT showed signs of uptake in the early phase (C), and MR spectroscopy showed no signs of lactate or lipid increases (D).
Figure 4
Figure 4
HE staining of the brainstem revealed a diffuse astrocytoma (A), GFAP positivity (B), an MIB‐1 index of 2.7% (C), and MGMT positivity (D).
Figure 5
Figure 5
HE staining of the left medial temporal lobe revealed a high‐grade astrocytoma (A), GFAP positivity (B), an MIB‐1 index of 9.1% (C), and MGMT negativity (D).
See this image and copyright information in PMC

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