Post-radiation glioma in a child - Case report and review of the literature

Lucio Palma, Roberto Vagnozzi, Luciana Annino, Pasquale Ciapetta, Alberto Maleci, Giampaolo Cantore

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A case of primary brain neoplasm is reported that developed 11 years after prophylactic brain irradiation and intrathecal methotrexate (MTX) given for acute lymphocytic leukemia (ALL) at the age of 3 years. Cases of supposed postirradiation gliomas in children seem to have increased in recent years, particularly following apparently successful treatment for ALL or medulloblastoma. This increse might reflect the increased number of long-surviving cancer children and thus suggest that brain irradiation may be a potential risk factor in this population. After reviewing some general data on neurooncogenesis, two points are stressed: (1) the child's brain is particularly susceptible to the mutagenic effects of ionizing radiation owing to physiologically active postnatal glial cell proliferation, which takes place in the cerebral hemispheres, especially during myelinogenesis; (2) MTX could promote glial neoplasm by enhancing reparative glial cell proliferation. Prospective studies seem necessary to show whether or not prophylactic brain radiaton in ALL plays an oncogenetic role. Nevertheless, besides recurrent leukemia, leukoencephalopathy, and radionecrosis, the remote possibility of radiation-induced glial neoplasma should always be considered in cases of children treated for leukemia who present with neurological complications.

Original languageEnglish
Pages (from-to)296-301
Number of pages6
JournalChild's Nervous System
Issue number5
Publication statusPublished - Oct 1988


  • Glioma
  • Lymphocytic leukemia
  • Pediatric cancer
  • Postradiation tumors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology


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