Pilocytic astrocytoma developing at the site of a previously treated medulloblastoma in a child

Background: After the achieved high cure rates, the survivors of medulloblastoma have come to face other complications associated with treatment regimes. One of these complications is secondary malignant neoplasm (SMN), which is rare but generally fatal. Case history: We report a case of an 8-year-old girl in whom a pilocytic astrocytoma developed at the site of previously excised medulloblastoma 26 months earlier. The patient had then received postoperative radiotherapy and chemotherapy for the treatment of medulloblastoma. Twenty-five months after the cessation of treatment, she had no complaint and physical examination was unremarkable, but a mass in the operation region was detected. Surgical excision of the secondary pilocytic astrocytoma was performed with a good clinical recovery without any evidence of residue or recurrence at 9-month follow-up. Conclusion: Clinicians must be vigilant for the risk of expected SMNs. Rigorous and prolonged follow-up of patients with central nervous system (CNS) tumors is warrant. © Springer-Verlag 2007.