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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:160-162, January 2005
© 2005 American Society of Neuroradiology

Case Report
BRAIN

Secondary Supratentorial Primitive Neuroectodermal Tumor following Irradiation in a Patient with Low-Grade Astrocytoma

Allan Y. Chen^a, Haidy Lee^a, Jonathan Hartman^b, Claudia Greco^c, Janice K. Ryu^a, Robert O’Donnell^e,f and James Boggan^d

^a Department of Radiation Oncology , University of California—Davis Medical Center, Sacramento, CA
^b Department of Radiology , University of California—Davis Medical Center, Sacramento, CA
^c Department of Pathology , University of California—Davis Medical Center, Sacramento, CA
^d Department of and Neurological Surgery University of California—Davis Medical Center, Sacramento, CA
^e Division of Hematology and Oncology , University of California—Davis Medical Center, Sacramento, CA
^f Northern California Veteran’s Administration Healthcare System , Sacramento, CA

Address reprint requests to A.Y. Chen, Department of Radiation Oncology, University of California–Davis Medical Center, Sacramento, CA 95817

Summary: We report a case of a supratentorial primitive neuroectodermal tumor (PNET) that occurred 12 years after cranial irradiation for a grade II astrocytoma. Neuroimaging was unable to distinguish between a recurrence of the original neoplasm and the development of a new, distinct entity. Pathologic review assisted by immunohistochemical staining, however, revealed a high-grade PNET. Although rare, PNET needs to be included in the differential diagnoses for previously irradiated patients, who develop recurrent brain tumors in the presence of uncharacteristic imaging features.