gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Glioblastoma, atypical meningioma and multiple cavernoma subsequent to chemotherapy and cranial irradiation for leucemia in childhood

Glioblastom, atypisches Meningeom und multiple Kavernome nach Chemotherapie und Bestrahlung bei Leukämie in der Kindheit

Meeting Abstract

  • corresponding author T. Schweitzer - Department of Neurosurgery, University of Würzburg
  • M. Meinhardt - Department of Neurosurgery, University of Würzburg
  • M. Warmuth-Metz - Department of Neuroradiology, University of Würzburg
  • W. Roggendorf - Department of Neuropathology, University of Würzburg
  • K. Roosen - Department of Neurosurgery, University of Würzburg
  • G.H. Vince

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 08.108

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Veröffentlicht: 8. Mai 2006

© 2006 Schweitzer et al.
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Objective: We report the case of a 33-year-old male patient who consulted our neurosurgical department in September 2003 because of headaches, vomiting and incoherent handwriting. The initial CT scan showed a contrast enhancing mass in the left postcentral region with surrounding edema and in other localizations small calcifications.

Methods: MRI scan confirmed the following: an enhancing mass in the left postcentral area, two small extraaxial tumours located right frontal and calcifications that form multifocal hypointense lesions possibly due to old minor bleedings.

Results: At the age of 3 years leucemia was diagnosed in this patient and treated with chemotherapy for 3 years and cranial irradiation. Testicular relapse at the age of six led to another 4 years of chemotherapy and testicular irradiation. At 13 years testosterone, one year later growth hormone replacement commenced, growth hormone replacement stopped after three years. As yet, complete remission of leucemia persists.

The enhancing tumour mass was operated in our neurosurgical department and histopathological findings confirmed the suspected glioblastoma multiforme WHO IV. Postoperative cranial irradiation with 53.4Gy (10/03). 2 months later the patient was admitted for chemotherapy. Control MRI before chemotherapy revealed a significant enlargement of the right frontal extraaxial mass. Another operation was performed and histopathological findings described a microcystic meningioma WHO II because of polymorph changes and an increased proliferation rate (Ki67). In January 2004 chemotherapy with temozolamide in cycles of 5 days every 28 days was started up until June 2005. Last report of the patient to our department in October 2005 due to spells of severe headache and blurred vision. The MRI scan (October 2005), however, showed no residual tumour or recurrence. No pathological findings in neurological or ophthalmological examination. CSF lab results were unobtrusive.

Conclusions: In this case a rare coincidence of glioblastoma, atypical meningioma and cavernoma after chemotherapy and irradiation is presented. Possible side effects of long temozolamide survivors are discussed.