Radiation-induced meningioma and high-grade glioma following craniospinal irradiation for medulloblastoma: a case report

Background: Cranial irradiation is known to carry the risk of late intracranial toxicities, most notably the development of secondary intracranial neoplasms. Both meningiomas and gliomas can develop as radiation-induced tumors. Radiation-induced meningiomas represent the most common secondary tumor in patients who have previously undergone cranial irradiation. Secondary gliomas are the second most common secondary tumor in patients with prior cranial radiation. Case Description: We present the case of a patient with a history of medulloblastoma who received craniospinal irradiation at the age of 29 years. She remained disease-free for nearly two decades until developing an occipital meningioma at the age of 53, which recurred despite surgery and radiotherapy. Eight years later, she was diagnosed with a high-grade astrocytic neoplasm within the prior radiation field. Despite additional treatment, her disease rapidly progressed, and she expired. Conclusion: This case highlights the late oncogenic risk associated with prior cranial irradiation in long-term survivors and emphasizes the necessity of lifelong clinical and radiographic surveillance. Uniquely, the patient developed two distinct radiation-induced neoplasms, suggesting heterogeneous secondary tumorigenesis following radiation exposure.