caa a22 4500 606216316 CHVBK 20210128101102.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s00701-015-2377-9 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2377-9 Glioblastoma after AVM radiosurgery. Case report and review of the literature [Elektronische Daten] [Artur Xhumari, Arben Rroji, Eugen Enesi, Teona Bushati, Kita Sallabanda Diaz, Mentor Petrela] Background: Stereotactic radiosurgery (SRS) is considered to be a relatively safe procedure in cerebral arteriovenous malformationmanagement. There are very few reported cases of SRS-associated/induced malignancies. Methods: We show the case of a 21-year-old female who presented with a 21-mm3 ruptured AVM in the right mesial frontocallosal region. Embolization and/or radiosurgery was proposed. She preferred radiosurgery. The AVM was treated with CyberKnife® SRS. Results: She presented behavior changes 6years after SRS. MRI showed a right subcortical frontal lesion with increased perfusion, more consistent with high-grade glioma. The lesion's center was within the irradiated region of the previous SRS, having received an estimated radiation dose of 4Gy. Pathological examination noted a hypercellular tumor showing astrocytic tumor cells with moderate pleomorphism in a fibrillary background, endothelial proliferation, and tumor necrosis surrounded by perinecrotic pseudopalisades. Numerous mitotic figures were seen. The appearances were those of glioblastoma, WHO grade IV, with neuronal differentiation. SRS-associated/-induced GBM after treatment of a large AM is exceptional. SRS-associated/-induced malignancies are mostly GBMs and occur on average after a latency of 9.4years, within very low-dose peripheral regions as well as the full-dose regions; 33.3% of patients were under 20years at the time of SRS, and in 66% the lesion treated was a vascular pathology. Conclusion: Although it is unlikely that the risk of radiation-induced cancer will change the current standard of practice, patients must be warned of this potential possibility before treatment. Springer-Verlag Wien, 2015 CyberKnife nationallicence Radiosurgery nationallicence Radioinduced nationallicence Glioblastoma nationallicence Brain tumor nationallicence AVM nationallicence Xhumari Artur Service of Neurosurgery, University Hospital Centre "Mother Teresa”, Kongresi i Manastirit, Nr. 210, Tirane, Albania aut Rroji Arben Service of Radiology, University Hospital Centre "Mother Teresa”, Tirana, Albania aut Enesi Eugen Service of Radiology, University Hospital Centre "Mother Teresa”, Tirana, Albania aut Bushati Teona Service of Pathology, University Hospital Centre "Mother Teresa”, Tirana, Albania aut Sallabanda Diaz Kita Service of Neurosurgery, University Hospital San Carlos, Madrid, Spain aut Petrela Mentor Service of Neurosurgery, University Hospital Centre "Mother Teresa”, Kongresi i Manastirit, Nr. 210, Tirane, Albania aut Acta Neurochirurgica Springer Vienna 157/5(2015-05-01), 889-895 0001-6268 157:5<889 2015 157 701 https://doi.org/10.1007/s00701-015-2377-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2377-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Xhumari Artur Service of Neurosurgery, University Hospital Centre "Mother Teresa”, Kongresi i Manastirit, Nr. 210, Tirane, Albania aut NATIONALLICENCE 700 1- Rroji Arben Service of Radiology, University Hospital Centre "Mother Teresa”, Tirana, Albania aut NATIONALLICENCE 700 1- Enesi Eugen Service of Radiology, University Hospital Centre "Mother Teresa”, Tirana, Albania aut NATIONALLICENCE 700 1- Bushati Teona Service of Pathology, University Hospital Centre "Mother Teresa”, Tirana, Albania aut NATIONALLICENCE 700 1- Sallabanda Diaz Kita Service of Neurosurgery, University Hospital San Carlos, Madrid, Spain aut NATIONALLICENCE 700 1- Petrela Mentor Service of Neurosurgery, University Hospital Centre "Mother Teresa”, Kongresi i Manastirit, Nr. 210, Tirane, Albania aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/5(2015-05-01), 889-895 0001-6268 157:5<889 2015 157 701