Post-radiation dedifferentiation of meningioma into osteosarcoma.

Vladimir Osipov¹ , Khang-Che Ho¹ , Hendrikus G Krouwer² , Glenn Meyer³ and Vinod B Shidham¹

¹Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA

²Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA

³Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA

author email corresponding author email

BMC Cancer 2002, 2:34doi:10.1186/1471-2407-2-34


Published:	3 December 2002

Abstract

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.