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Benign skull and subdural lesions in patients with prior medulloblastoma therapy

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Abstract

Purpose

To report on our institutional cohort of patients and review the literature of medulloblastoma patients who developed skull/subdural-based lesions following treatment.

Methods

Following institutional review board (IRB) approval, we retrospectively reviewed the medical records of four children with a history of treated medulloblastoma who developed non-specific skull-based/subdural lesions incidentally found on surveillance imaging.

Results

Biopsies of the lesions proved the pathology to be low grade and included inflammatory myofibroblastic tumor, cortical fibrous defect consistent with fibroma, fibrous tissue, and fibrous dysplasia. The finding of calvarial or subdural fibrous lesions in children following therapy for medulloblastoma was noted in four out of 201 (136 with available follow-up data) medulloblastoma patients seen or discussed in our institution over the past 10 years.

Conclusions

These lesions can grow over time and pose a differential diagnostic challenge with metastatic disease when identified. The skull and subdural space should be scrutinized for secondary lesions on surveillance imaging of patients with medulloblastoma who have received craniospinal irradiation as knowledge of this benign occurrence will assist with management.

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All relevant data is included.

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Authors and Affiliations

  1. Division of Hematology-Oncology, Neuro-Oncology & Stem Cell Transplantation, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Chicago, IL, 60611-2991, USA

    Kristiyana Kaneva & Stewart Goldman

  2. Division of Pathology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Nitin Wadhwani

  3. Division of Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Arthur J. DiPatri Jr

  4. Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 9, Chicago, IL, 60611-2991, USA

    Susan Palasis & Jessie Aw-Zoretic

Authors
  1. Kristiyana Kaneva
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  2. Nitin Wadhwani
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  3. Arthur J. DiPatri Jr
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  4. Susan Palasis
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  5. Stewart Goldman
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  6. Jessie Aw-Zoretic
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Contributions

All authors have contributed significantly to the design, data collection, and writing of this manuscript.

Corresponding authors

Correspondence to Kristiyana Kaneva or Jessie Aw-Zoretic.

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The authors declare that there are no conflicts of interest.

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Institutional review board approval was obtained for completion of this study.

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Kaneva, K., Wadhwani, N., DiPatri, A.J. et al. Benign skull and subdural lesions in patients with prior medulloblastoma therapy. Childs Nerv Syst 37, 359–366 (2021). https://doi.org/10.1007/s00381-020-04874-2

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  • DOI: https://doi.org/10.1007/s00381-020-04874-2

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