De Novo Cavernous Malformation after Radiosurgery.docVIP

Open Journal of Modern Neurosurgery, 2013, 3, 1-3 /10.4236/ojmn.2013.31001 Published Online January 2013 (/journal/ojmn) De Novo Cavernous Malformation after Radiosurgery Catarina Viegas, Bruno Santiago, Joana Boléo Tomé, Manuel Cunhae Sá Department of Neurosurgery, Hospital Garcia de Orta, Almada, Portugal Email: cata_pv@ Received December 28, 2011; revised January 31, 2012; accepted March 7, 2012 ABSTRACT Background: The general use of radiation therapy and radiosurgery as first-line or adjuvant treatment of central nerv- ous system (CNS) lesions has been associated with several harmful effects. Case Description: We report the case of a 16-year-old male patient, submitted at the age of seven to surgical removal of a world heath organization (WHO) grade II diffuse astrocytoma and referred for adjuvant radiosurgery after three further surgeries due to local recurrences. Seven years after radiosurgical treatment, he presented with symptoms of intracranial hypertension. Magnetic resonance imaging (MRI) at the time showed a cavernous malformation in the tumor bed, histologically confirmed, without tu- moral recurrence. Conclusion: This case report emphasizes the relation between radiosurgery and the appearance of the novo cavernous malformations, only described previously in one adult patient. Keywords: Cavernous Malformation; Radiosurgery; Radiation Induced Cavernoma; Grade II Astrocytoma 1. Introduction cific imaging modality for the diagnosis of these lesions. Typical MRI features include a mixed signal lesion with “popcorn” appearance surrounded by a hypointense rim. We report the case of a 16-year old boy with a low grade astrocytoma treated with surgery and radiosurgery, who subsequently developed a cavernous malformation in the area of the radiated bed. The use of radiation therapy and radiosurgery as primary or adjuvant treatment of central nervous system (CNS) tumors has been associated with a wide range of