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Case Reports in Oncological Medicine
Volume 2012 (2012), Article ID 290905, 4 pages
http://dx.doi.org/10.1155/2012/290905
Case Report

Secondary Glioblastoma Multiforme in a Child with Disseminated Juvenile Pilocytic Astrocytoma

1The Departments of Neurosurgery, San Diego and Rady Children’s Hospital, University of California, 3020 Children's Way San Diego, San Diego, CA 92123, USA
2The Departments of Pediatrics, San Diego and Rady Children’s Hospital, University of California, 3020 Children's Way San Diego, San Diego, CA 92123, USA
3The Departments of Neurosciences, San Diego and Rady Children’s Hospital, University of California, 3020 Children's Way San Diego, San Diego, CA 92123, USA
4Division of Child Neurology, Rady Children’s Hospital San Diego, University of California San Diego, 8010 Frost Street Suite 400, 3020 Children's Way San Diego, San Diego, CA 92123, USA

Received 17 September 2012; Accepted 24 October 2012

Academic Editors: D. Chua, J. Itami, J. M. Ribera, and D. Yin

Copyright © 2012 C. S. Amene et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Secondary glioblastoma multiforme (sGBM) can occur after a long latency period following radiation treatment of various diseases including brain tumors, leukemia, and more benign disorders like tinea capitis. Outcomes of radiation-induced sGBM remain poor in both children and adults. We report a case of a 16-year-old girl with a history of disseminated juvenile pilocytic astrocytoma treated with chemotherapy and craniospinal radiation 9 years prior who developed sGBM in the absence of a tumor predisposition syndrome. She presented with a several-week history of headaches and no acute findings on computed tomography compared to baseline neuroimaging 3 months prior. Repeat computed tomography performed just 3 weeks later for worsening headaches revealed a new large posterior fossa tumor where pathology confirmed the diagnosis of sGBM. In spite of maximal surgical resection, reirradiation, and adjuvant chemotherapy, she died 1 year postdiagnosis. Our case highlights the potential late effects of high-dose cranial radiation, how symptomatology may precede neuroimaging findings, and the rapid formation of sGBM that mirrors that of de novo Glioblastoma Multiforme.