Diffuse high-grade gliomas as second malignant neoplasms after radio-chemotherapy for pediatric malignancies. Romeike BF, Kim YJ, Steudel WI, Graf N. Institut fur Neuropathologie, Universitatsklinikum des Saarlandes, 66421, Homburg/Saar, Germany, bernd.romeike@uniklinikum-saarland.de. OBJECTS: Diffuse high-grade gliomas are known to develop in children after cranial irradiation for other malignancies. Here, clinicopathological characteristics are outlined. METHODS: Nine children received cranial irradiation and chemotherapy for medulloblastoma (n=2) or acute lymphoblastic leukemia (n=7). They developed a high-grade glioma 7-14 years thereafter. Clinical charts, radiologic findings, and pathologic specimens were reviewed. Archival material was stained immunohistochemically. CONCLUSION: Gliomas evolving as second malignant neoplasms show peculiarities and differ in some aspects from their "spontaneous" counterparts. Most are supratentorial, contrast-enhancing, space-occupying lesions. They are composed mainly of small undifferentiated cells, which are mainly negative for glial fibrillary acidic protein and positive for microtubule associated proteins 2 (MAP2). Epidermal growth factor receptor labeling could not be detected in any of them. Ki67-labeling was usually high, whereas p53- and h-ras p21-staining was variable. The median survival was only 12 months despite intensive treatment. Childs Nerv Syst. 2006 Oct 5; [Epub ahead of print] PMID: 17021727 [PubMed - as supplied by publisher] Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.