Delayed malignant transformation of petroclival meningioma to chondrosarcoma after stereotactic radiosurgery

Rohan R. Lall, Rishi Rajiv Lall, Timothy R. Smith, Kyung Hwa Lee, Qinwen Mao, John A. Kalapurakal, Maryanne H. Marymont, James P. Chandler

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Stereotactic radiosurgery (SRS) is often used as adjuvant treatment for residual or recurrent tumor following microsurgical resection of posterior fossa meningiomas. SRS is associated with excellent rates of local control, however long-term complications remain unclear. Secondary malignancy is an often discussed but rarely described complication of SRS. We present a 56-year-old woman who underwent near total resection of a petroclival meningioma, followed by two episodes of SRS over the ensuing 8 years for local recurrence. She returned 14 years after initial diagnosis with neurologic deterioration and was found to have massive recurrence. Pathology was consistent with high-grade chondrosarcoma. The tumor continued to progress despite debulking and proton-beam therapy and the patient died of medical complications. To our knowledge this is the first report of malignant transformation of a meningioma to high-grade chondrosarcoma, further notable due to the remarkable clinical course and delayed presentation after initial surgery and radiosurgery. Though this may have been a de novo tumor, it is also possible that this represents a case of radiation-induced neoplasm. Although SRS continues to gain favor as a treatment modality, delayed malignant degeneration is a potential complication and physicians should counsel patients of this risk.

Original languageEnglish (US)
Pages (from-to)1225-1228
Number of pages4
JournalJournal of Clinical Neuroscience
Volume21
Issue number7
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Chondrosarcoma
Radiosurgery
Meningioma
Neoplasms
Radiation-Induced Neoplasms
Proton Therapy
Recurrence
Nervous System
Pathology
Physicians
Therapeutics

Keywords

  • Chondrosarcoma
  • Malignant degeneration
  • Meningioma
  • Neuropathology
  • Radiosurgery
  • SRS
  • Stereotactic radiosurgery

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Delayed malignant transformation of petroclival meningioma to chondrosarcoma after stereotactic radiosurgery. / Lall, Rohan R.; Lall, Rishi Rajiv; Smith, Timothy R.; Lee, Kyung Hwa; Mao, Qinwen; Kalapurakal, John A.; Marymont, Maryanne H.; Chandler, James P.

In: Journal of Clinical Neuroscience, Vol. 21, No. 7, 01.01.2014, p. 1225-1228.

Research output: Contribution to journalArticle

Lall, Rohan R. ; Lall, Rishi Rajiv ; Smith, Timothy R. ; Lee, Kyung Hwa ; Mao, Qinwen ; Kalapurakal, John A. ; Marymont, Maryanne H. ; Chandler, James P. / Delayed malignant transformation of petroclival meningioma to chondrosarcoma after stereotactic radiosurgery. In: Journal of Clinical Neuroscience. 2014 ; Vol. 21, No. 7. pp. 1225-1228.
@article{f4e9891a6d674e8da57ec9b232c8e61e,
title = "Delayed malignant transformation of petroclival meningioma to chondrosarcoma after stereotactic radiosurgery",
abstract = "Stereotactic radiosurgery (SRS) is often used as adjuvant treatment for residual or recurrent tumor following microsurgical resection of posterior fossa meningiomas. SRS is associated with excellent rates of local control, however long-term complications remain unclear. Secondary malignancy is an often discussed but rarely described complication of SRS. We present a 56-year-old woman who underwent near total resection of a petroclival meningioma, followed by two episodes of SRS over the ensuing 8 years for local recurrence. She returned 14 years after initial diagnosis with neurologic deterioration and was found to have massive recurrence. Pathology was consistent with high-grade chondrosarcoma. The tumor continued to progress despite debulking and proton-beam therapy and the patient died of medical complications. To our knowledge this is the first report of malignant transformation of a meningioma to high-grade chondrosarcoma, further notable due to the remarkable clinical course and delayed presentation after initial surgery and radiosurgery. Though this may have been a de novo tumor, it is also possible that this represents a case of radiation-induced neoplasm. Although SRS continues to gain favor as a treatment modality, delayed malignant degeneration is a potential complication and physicians should counsel patients of this risk.",
keywords = "Chondrosarcoma, Malignant degeneration, Meningioma, Neuropathology, Radiosurgery, SRS, Stereotactic radiosurgery",
author = "Lall, {Rohan R.} and Lall, {Rishi Rajiv} and Smith, {Timothy R.} and Lee, {Kyung Hwa} and Qinwen Mao and Kalapurakal, {John A.} and Marymont, {Maryanne H.} and Chandler, {James P.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.jocn.2013.11.015",
language = "English (US)",
volume = "21",
pages = "1225--1228",
journal = "Journal of Clinical Neuroscience",
issn = "0967-5868",
publisher = "Churchill Livingstone",
number = "7",

}

TY - JOUR

T1 - Delayed malignant transformation of petroclival meningioma to chondrosarcoma after stereotactic radiosurgery

AU - Lall, Rohan R.

AU - Lall, Rishi Rajiv

AU - Smith, Timothy R.

AU - Lee, Kyung Hwa

AU - Mao, Qinwen

AU - Kalapurakal, John A.

AU - Marymont, Maryanne H.

AU - Chandler, James P.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Stereotactic radiosurgery (SRS) is often used as adjuvant treatment for residual or recurrent tumor following microsurgical resection of posterior fossa meningiomas. SRS is associated with excellent rates of local control, however long-term complications remain unclear. Secondary malignancy is an often discussed but rarely described complication of SRS. We present a 56-year-old woman who underwent near total resection of a petroclival meningioma, followed by two episodes of SRS over the ensuing 8 years for local recurrence. She returned 14 years after initial diagnosis with neurologic deterioration and was found to have massive recurrence. Pathology was consistent with high-grade chondrosarcoma. The tumor continued to progress despite debulking and proton-beam therapy and the patient died of medical complications. To our knowledge this is the first report of malignant transformation of a meningioma to high-grade chondrosarcoma, further notable due to the remarkable clinical course and delayed presentation after initial surgery and radiosurgery. Though this may have been a de novo tumor, it is also possible that this represents a case of radiation-induced neoplasm. Although SRS continues to gain favor as a treatment modality, delayed malignant degeneration is a potential complication and physicians should counsel patients of this risk.

AB - Stereotactic radiosurgery (SRS) is often used as adjuvant treatment for residual or recurrent tumor following microsurgical resection of posterior fossa meningiomas. SRS is associated with excellent rates of local control, however long-term complications remain unclear. Secondary malignancy is an often discussed but rarely described complication of SRS. We present a 56-year-old woman who underwent near total resection of a petroclival meningioma, followed by two episodes of SRS over the ensuing 8 years for local recurrence. She returned 14 years after initial diagnosis with neurologic deterioration and was found to have massive recurrence. Pathology was consistent with high-grade chondrosarcoma. The tumor continued to progress despite debulking and proton-beam therapy and the patient died of medical complications. To our knowledge this is the first report of malignant transformation of a meningioma to high-grade chondrosarcoma, further notable due to the remarkable clinical course and delayed presentation after initial surgery and radiosurgery. Though this may have been a de novo tumor, it is also possible that this represents a case of radiation-induced neoplasm. Although SRS continues to gain favor as a treatment modality, delayed malignant degeneration is a potential complication and physicians should counsel patients of this risk.

KW - Chondrosarcoma

KW - Malignant degeneration

KW - Meningioma

KW - Neuropathology

KW - Radiosurgery

KW - SRS

KW - Stereotactic radiosurgery

UR - http://www.scopus.com/inward/record.url?scp=84901194055&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901194055&partnerID=8YFLogxK

U2 - 10.1016/j.jocn.2013.11.015

DO - 10.1016/j.jocn.2013.11.015

M3 - Article

VL - 21

SP - 1225

EP - 1228

JO - Journal of Clinical Neuroscience

JF - Journal of Clinical Neuroscience

SN - 0967-5868

IS - 7

ER -