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11/89. osteosarcoma and fibrosarcoma caused by postoperative radiotherapy for a pituitary adenoma. Case report.

    Sarcomatous change is a rare complication of postoperative radiotherapy for pituitary adenomas. The authors report on what they believe to be the first case in which fibrosarcoma and, later, osteosarcoma developed during a 14-year period following surgery and radiotherapy for a nonsecreting pituitary macroadenoma.
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keywords = pituitary
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12/89. Treated Wilm's tumor in childhood as potential risk factor for second thyroid cancer.

    The potential risk of a treatment-induced second neoplasia affecting the thyroid is well known after radiation therapy for several types of cancer, but few cases have been related to incidental irradiation for Wilms' tumor. We report a case of a papillary thyroid carcinoma discovered in a young patient 15 years after treatment of a Wilms' tumor. An 18-year-old man was referred to our Endocrinological Department for a single 3 cm nodule in the right lobe of the thyroid. His past medical history included at the age of 2 years surgical resection, chemotherapy (actinomycin-D and vincristine) and cesium radiation therapy to the right side for a Wilms' tumor in stage III: a total dose of 7700 rads was delivered to an area of 17 x 10 cm in the right flank. After fine-needle demonstration of a follicular thyroid lesion, the patient underwent right lobectomy, followed by total thyroidectomy for histologic diagnosis of a follicular variant papillary cancer. Residual thyroid tissue was ablated by iodine-131 administration (3700 MBq), but scanning after therapeutic iodine showed radioactive uptake in the left regional lymph nodes, with elevated serum thyroglobulin off therapy (830 ng/ml). magnetic resonance imaging confirmed the presence of lymph node enlargements and bilateral neck dissection was performed, followed by radioiodine treatment (3700 MBq) and thyroxine suppressive therapy. After 3-year follow-up the patient is disease-free. Although few cases of thyroid cancer have been reported in the literature after irradiation for a Wilms' tumor during childhood, this association should be considered in the long-term follow-up.
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ranking = 0.00049048856165253
keywords = lobe
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13/89. Post-radiation dedifferentiation of meningioma into osteosarcoma.

    BACKGROUND: A number of osteoblastic meningiomas, primary osteosarcomas of the meninges, and post-radiation osteosarcomas of the head have been reported. However, postradiation dedifferentiation of meningioma into osteosarcoma has not been reported previously. CASE PRESENTATION: In 1987 a caucasian man, then 38 years old, presented with a pituitary macroadenoma. He underwent a subtotal resection of the tumor and did well until 1990 when a recurrent tumor was diagnosed. This was treated with subtotal resection of the tumor, followed by radiation therapy for six weeks to a total of 54 Gy. He was considered "disease-free" for nearly ten years. However, most recently in July 2000, he presented with a visual field deficit due to a second recurrence of his pituitary macroadenoma, now with suprasellar extension. At this time, as an incidental finding, a mass attached to the dura was noted in the left parietal hemisphere. This dura-based mass had grown rapidly by January 2001 and was excised. It showed histological, immunohistochemical, and electron microscopic features of malignant meningioma and osteosarcoma with a sharp demarcation between the two components. CONCLUSIONS: We report a rare case of a radiation induced dedifferentiation of meningioma into osteosarcoma, which has not been reported previously.
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keywords = pituitary
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14/89. radiation-induced osteosarcoma of the calvaria--case report.

    The authors report a case of radiation-induced calvarial osteosarcoma. A 58-year-old female received subtotal removal of the pituitary adenoma and 5000 rads postoperative irradiation. Seven years later, an osteoblastic osteosarcoma occurred in the frontotemporal region. She received total tumor removal and chemotherapy. However, computed tomography subsequently revealed multiple small lesions at the margin of the bone flap. A chest x-ray film demonstrated lung metastasis. Local recurrence and lung metastasis require careful attention in radiation-induced osteosarcoma patients.
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keywords = pituitary
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15/89. Irradiation-induced polyglandular neoplasia of the head and neck.

    Eighteen patients are presented with twenty-one tumors of the head and neck, which include ten salivary gland tumors and eight parathyroid adenomas. Eight of the patients also had thyroid neoplasms. All patients had a history of prior irradiation to the head and neck. Seventy per cent of the salivary gland tumors and 37 per cent of the thyroid tumors were malignant. Recommendations are made for detection and treatment.
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ranking = 0.023012456147161
keywords = gland
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16/89. radiation-induced tumor after stereotactic radiosurgery and whole brain radiotherapy: case report and literature review.

    radiation-induced neoplasms are extremely rare after stereotactic radiosurgery. To date, only 3 cases meet Cahan's criteria in the world literature. We present a fourth case of a radiation-induced neoplasm arising after radiosurgery. The patient is a 43-year-old woman who presented with a right cerebellar anaplastic astrocytoma 64 months after radiosurgery for metastatic melanoma. Initially, 3 brain metastases involving the inferior right temporal (2 tumors) and right frontal regions were treated. Following radiosurgery, the patient underwent whole brain radiotherapy (37.5 Gy). Twenty-two months later, a second radiosurgical procedure was performed for a recurrent right temporal lobe metastasis. The area of cerebellum where the glioma developed received a maximum dose of 7.7 and 1.5 Gy during the 2 procedures, respectively. Support that radiosurgery contributed to the development of this glioma are the tumor's location and the rarity of adult cerebellar astrocytomas. The risk of radiation-induced tumors after radiosurgery is unknown. To better define the incidence of radiation-induced neoplasms after radiosurgery, all potential cases should be presented and discussed in an open, candid fashion.
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ranking = 0.00024524428082626
keywords = lobe
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17/89. Differentiation of benign vs. malignant mass in a postirradiation cerebral arteriovenous malformation by 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography.

    This report demonstrates the findings on two 2-deoxy-2-[(18)F]fluoro-D-glucose positron emission tomography (FDG-PET) brain scans of a 16-year-old girl with previous radiation therapy for an arteriovenous malformation (AVM) that was transformed by radiation therapy to a mass in a deep and relatively inaccessible cerebral location. Clinical neurologic examination, brain CT without and with contrast, 1.5 T MRI of the brain without and with contrast, magnetic resonance angiography (MRA), (1)H magnetic resonance spectroscopic imaging (MRSI) of the brain, and two FDG brain PET scans were performed to characterize the lesion. magnetic resonance imaging (MRI) and (1)H MR spectroscopic findings showed a mass and surrounding vasogenic edema in the deep left parietal lobe suggestive of malignant angiosarcoma. However, an FDG-PET scan of the brain identified a large area of hypometabolism involving the left parietal lobe. The PET findings were unchanged compared to a FDG-PET scan performed one year prior, suggesting that the lesion was benign. In addition, an MRI performed six months after the second PET scan was also consistent with a benign lesion, and was unchanged from the MRI performed two years prior. We present the first detailed imaging characteristics of a mass of high clinical suspicion for malignancy resulting from transformation of an arteriovenous malformation after radiosurgery treatment. Two FDG-PET scans performed for a one-year time interval provided a noninvasive method to establish that the lesion had nonmalignant characteristics.
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ranking = 0.00049048856165253
keywords = lobe
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18/89. meningioma developed 25 years after radiation therapy for Cushing's disease.

    A 44-year-old woman who had been therapeutically irradiated with 45 Gy to the sellar lesion for Cushing's disease has been in remission for 25 years. A large but asymptomatic brain tumor was accidentally found in the right middle fossa by a routine follow-up computed tomography. Upon surgical removal of the tumor, the histology revealed a fibroblastic meningioma. Although the incidence of meningioma following irradiation to pituitary adenoma is rare, a follow-up computed tomography should be taken to any possible late onset, and curable complication.
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ranking = 0.16666666666667
keywords = pituitary
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19/89. radiation-induced medulloblastoma in an adult: a functional imaging study.

    We describe functional imaging findings using MRI, 1H-magnetic resonance spectroscopy and positron emission tomography in a case of radiation-induced medulloblastoma following radiotherapy for pineal gland tumor. MRS showed a prominent choline peak; FDG, 11C-Met and 11C-choline PET showed a minimal glucose, increased methionine and choline uptake.
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ranking = 0.0038354093578602
keywords = gland
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20/89. Papillary adenocarcinoma in thyroid hemiagenesis.

    Variation in the gross anatomy of the thyroid gland is relatively common. Although thyroid hemiagenesis is felt to be a rare anomaly, its incidence is probably underestimated as the diagnosis is usually incidental. The case of a 41-year-old woman with right thyroid hemiagenesis associated with papillary adenocarcinoma is presented. The diagnosis of hemiagenesis was established by isotope imaging and surgical exploration for a benign nodule. Seven years later she was seen with a recurrent neck mass, and an isotope scan revealed it to be a cold thyroid nodule. As she was diagnosed to have papillary adenocarcinoma, total thyroid lobectomy was performed and at present she remains disease-free.
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ranking = 0.0040806536386864
keywords = gland, lobe
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