Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Nov 24, 2019; 10(11): 375-381
Published online Nov 24, 2019. doi: 10.5306/wjco.v10.i11.375
Radiation-induced malignant rhabdoid tumour of the hypothalamus in an adult: A case report
Pei-Meng Ng, Peh-Hueh Low, Donald Ngian-San Liew, Albert Sii-Hieng Wong
Pei-Meng Ng, Peh-Hueh Low, Donald Ngian-San Liew, Albert Sii-Hieng Wong, Department of Neurosurgery, Sarawak General Hospital, Kuching 93586, Sarawak, Malaysia
Author contributions: Ng PM and Low PH reviewed the literature and contributed to manuscript drafting; Wong ASH and Liew DNS were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient’s parent for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Peh-Hueh Low, MBBS, Neurosurgeon, Department of Neurosurgery, Sarawak General Hospital, Kuching 93586, Sarawak, Malaysia. peh.hueh@gmail.com
Telephone: +60-19-2188599
Received: May 23, 2019
Peer-review started: May 23, 2019
First decision: August 2, 2019
Revised: October 10, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: November 24, 2019
Processing time: 187 Days and 11.8 Hours
Abstract
BACKGROUND

Rhabdoid tumours of the central nervous system are highly malignant and extremely rare in adults. To the best of our knowledge, only 87 cases of malignant rhabdoid tumour have been reported to date, inclusive of 4 cases with presumed radiation-induced aetiology. We report a case of malignant rhabdoid tumour in an adult with presumed radiation-induced aetiology to enrich the armamentarium of this disease entity, which may have some implications for early diagnosis and treatment of this rare disease in the future.

CASE SUMMARY

A 27-year-old male, who was exposed to cranial irradiation at the age of 4 years as part of the treatment for acute lymphoblastic leukaemia, presented with symptoms of raised intracranial pressure for one week. Brain magnetic resonance imaging revealed a heterogeneously enhancing lesion at the hypothalamus. Stereotactic biopsy was performed. Histopathological examination of the lesion showed malignant rhabdoid tumour. The disease progressed rapidly, with manifestation of leptomeningeal spread. He was started on craniospinal irradiation but treatment was suspended after 5.4 Gy, as he developed myelosuppression. His clinical condition deteriorated rapidly, and he succumbed to his illness within 2 mo.

CONCLUSION

This fifth case of radiation-induced central nervous system rhabdoid tumour re-enforces the aggressive nature of this disease with poor prognosis.

Keywords: Malignant rhabdoid tumour; Atypical teratoid rhabdoid tumour; Radiation induced malignancy; Case report

Core tip: Malignant rhabdoid tumours of the central nervous system are highly malignant, with a grave prognosis. Occurrence in adults is extremely rare. Due to the paucity of available data, treatment recommendations for adults are derived mainly from paediatric data. Despite being a dismal disease, prognosis in children has been more encouraging recently due to the continuous refinement of treatment strategies. We report a case of malignant rhabdoid tumour in an adult with presumed radiation-induced aetiology, with the hope to enrich the armamentarium of this disease entity and provide some implications for early diagnosis and treatment of this disease in the future.