GC-22VASCULAR MALFORMATION AS A LATE SEQUELAE IS QUITE FREQUENT AMONG LONG-TERM SURVIVORS AFTER RADIATION TREATMENT FOR INTRACRANIAL GERM CELL TUMOR

Abstract

INTRODUCTION: Vascular malformation following radiation treatment is a known phenomenon but the incidence is not well recognized. METHOD: Eight patients with intracranial germ cell tumor, followed more than 10 years, were examined with MRI susceptibility-weighted imaging (SWI) or T2-star imaging. There were 5 germinomas, 1 immature teratoma, 1 mixed germ cell tumor and 1 choriocarcinoma.The tumor locations were 6 in pineal, 1 in neurohypophysis and 1 in basal ganglia.The age at startedtreatmentwere4years to 21 years (median16years) and median follow-up period was 13 years (10-21years). All the patients received radiation-chemotherapy and the dose range of radiation was 24- 54 Gy (median 50Gy). Three patients with germinoma experienced recurrence during the follow-up period and were rescued with radiation/chemotherapy. RESULTS: Cavernous angiomas were found in all patients and venous malformation was found in one patient. One patient developed symptomatic bleeding (headache only) from the cavernous angioma 4 years later after initial treatment but the symptom was subsided during the course without surgical intervention. CONCLUSION: Vascular anomaly was found in 100% of the patients which was far higher than previous reports. Further follow-up will be needed for understanding natural history of these vascular malformations