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Focal Cranial Hyperostosis From Meningioma: A Complication From Previous Radiation Treatment for Childhood T-Cell Acute Lymphoblastic Leukemia

Songdej, Natthapol MD, MPH

Journal of Pediatric Hematology/Oncology: March 2014 - Volume 36 - Issue 2 - p 148–149
doi: 10.1097/MPH.0b013e3182830d56
Radiology Corner

Nearly 75% of childhood cancer survivors will experience an adverse late effect from previous therapy. In patients previously treated with cranial irradiation, the late effect can manifest as secondary central nervous system tumors. Presented is a case of a 20 year man with a history of T-cell lymphoblastic leukemia diagnosed at age 22 months, treated with chemotherapy and cranial irradiation. He had developed increasing prominence of the top of his head over several months. Plain radiograph showed frontal calvarium thickening with focal “hair-on-end” periosteal reaction. Magnetic resonance imaging revealed an enhancing dural-based mass with transcalvarial extension, confirmed after resection to be meningioma (World Health Organization Grade I). This case illustrates an atypical presentation of a late effect of childhood cancer treatment and highlights the need to be informed about prior treatments received and potential attendant complications.

Fox Chase Cancer Center, Temple University, Philadelphia, PA

The authors declare no conflict of interest.

Reprints: Natthapol Songdej, MD, MPH, Fox Chase Cancer Center, Temple University, 333 Cottman Avenue, Philadelphia, PA 19111 (e-mail:

Received November 18, 2012

Accepted December 13, 2012

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