Radiation-induced malignant meningioma following proton beam therapy for a choroidal melanoma

Claudia Scaringi, Giuseppe Minniti, Alessandro Bozzao, Felice Giangaspero, Teresa Falco, Alessandro Greco, Vitaliana De Sanctis, Andrea Romano, Riccardo Maurizi Enrici

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We report a woman with malignant meningioma diagnosed 9 years after the treatment of a choroidal melanoma with proton beam therapy. The risk of secondary cancers is a well-known adverse late effect of radiation therapy, especially with the use of advanced techniques such as intensity-modulated radiation therapy. However, this risk may be less with the use of proton beam therapy. A 79-year-old woman presented with symptoms of enophthalmos, ptosis and paralysis of the left medial rectus muscle. She had previously been successfully treated for a choroidal melanoma of the left eye with proton beam therapy (total dose: 60 cobalt gray equivalents) following local resection. MRI showed a lesion in the left cavernous sinus with extension into the orbit and a subsequent biopsy revealed a papillary meningioma. The cavernous tumor was treated with photon radiotherapy (total dose: 54 Gy) which achieved an initial partial response. However, 8 months later the tumor extensively metastasized to the skull and the spine and the patient died 1 year after the treatment. The incidence of secondary malignancies after proton beam therapy is low but not negligible, therefore, it must be taken into account when planning a treatment as secondary tumors may present with a highly aggressive behaviour.

Original languageEnglish
Pages (from-to)1036-1037
Number of pages2
JournalJournal of Clinical Neuroscience
Issue number6
Publication statusPublished - Jun 1 2015


  • Proton beam therapy
  • Radiation-induced meningioma
  • Secondary cancers

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Physiology (medical)


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