Radiation-Induced Low-Grade Glioma following Radiotherapy for Squamous Cell Carcinoma of the Scalp: Case Report and Literature Review

TL;DR

A rare case of a brain tumor caused by previous low-dose radiation therapy for skin cancer is reported, highlighting the importance of considering such diagnoses.

Contribution

This case report adds to the limited literature on radiation-induced low-grade gliomas following scalp radiotherapy.

Findings

A 50-year-old woman developed a Grade 2 diffuse astrocytoma after receiving low-dose radiation for scalp squamous cell carcinoma.

The case fits the clinical criteria for radiation-induced glioma despite the patient's older age and low radiation dose.

Genetic studies were not performed, but the diagnosis was based on clinical history and histopathology.

Abstract

Radiation-induced gliomas (RIGs) were reported in the literature in general. In most of the reported cases and the reviewed articles, patients have a history of primary intracranial tumors like craniopharyngioma, medulloblastoma, and ependymoma, and the commonly resulting secondary tumors are meningiomas and sarcomas, mainly not gliomas. Case Presentation. A 50-year-old woman had a history of left scalp temporal region periauricular squamous cell carcinoma, which was verified by the histology result of a biopsy 11 years ago. On the basis of that, she began receiving low-dose radiation sessions when she was 39 years old. She exhibits cranial symptoms and a radiological sign of cancer 9 years later. After a successful excision procedure, histology revealed diffuse astrocytoma Grade 2. Our case is suspected to fit the criteria for being identified as RIG, which is a syndrome that is thought to occur infrequently in the literature.

In conclusion, the way that this condition manifested in our case is considered rare due to old age and the low doses of radiation received. Despite being an important part to confirm the diagnosis, genetic studies were unfortunately not done in our case, but we mainly based on the criteria mentioned by Cahan et al., which are mainly taken from the clinical history and histopathology. Here, we present an example of considering such a diagnosis when suspected clinically, but a genetic study for confirmation should be thought of even if it is not available in the locality.

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