Post-radiation reactive changes in a single vertebral body mimicking metastatic pineoblastoma: Case report

Matthew C. Tate, Anurahda Banerjee, Scott R. Vandenberg, Tarik Tihan, John H. Chi, Christopher P. Ames, Andrew T. Parsa

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

This 18-year-old woman presented with headache and diplopia over several months and was found to have an enhancing pineal tumor with resultant obstructive hydrocephalus. Following standard preoperative diagnostic tests, including spinal axis imaging, the patient was taken to the operating room for an endoscopic third ventriculostomy to relieve hydrocephalus and then subsequently underwent a craniotomy for gross-total resection of the pineal mass. The patient was discharged after an uneventful hospital course and received standard adjuvant cranial-spinal radiation and chemotherapy as an outpatient. Follow-up imaging 1 year after surgery demonstrated a metabolically active, lytic lesion in the C-3 vertebral body and new lung lesions suggesting a metastatic pineoblastoma. The patient underwent a C-3 anterior corpectomy and reconstruction without complication as aggressive therapy for presumed metastatic disease. Final pathological results from the vertebral lesion were consistent with radiation-induced reactive changes, not metastatic pineoblastoma as originally suspected. The patient recovered well and remains symptom free. To the authors' knowledge this is the first reported case of reactive changes mimicking metastasis in a single vertebral body following standard therapy for resected primary pineoblastoma.

Original languageEnglish (US)
Pages (from-to)479-483
Number of pages5
JournalJournal of Neurosurgery: Pediatrics
Volume4
Issue number5
DOIs
StatePublished - Nov 1 2009

Keywords

  • Metastatic pineoblastoma
  • Radiation therapy
  • Spine

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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