Radiation-induced malignant rhabdoid tumour of the hypothalamus in an adult: A case report

Table 1 Summary of patients, symptoms, treatments, and outcomes of radiation-induced malignant rhabdoid tumour

Case	Age (yr)	Gender	Symptom	Location	Treatment	Survival	Outcome
Padua et al[1]	17	Male	Headache	Right frontal	Surgery (partial resection), radiotherapy	15 mo	Alive
Kuge et al[2]	20	Female	Severe headache, increased ICP symptoms	Pineal	Surgery (biopsy), gamma knife radiosurgery	27 mo	Died
Gorayski et al[3]	58	Female	Headache, recurrent syncopal events, behavioural changes	Right parietotemporal	Surgery (gross total resection), radiotherapy	20 mo	Died
Oliveira et al[4]	22	Female	headache, nausea, vomiting	Frontal	Surgery (partial resection)	4 d	Died
Our case	27	Male	Headache, vomiting, visual disturbance	Hypothalamus	Surgery (biopsy), radiotherapy	2	Died

ICP: Intracranial pressure.

Table 2 Summary of immunohistological findings of radiation-induced malignant rhabdoid tumour

Case	Padua et al[1]	Kuge et al[2]	Gorayski et al[3]	Oliveira et al[4]	Our case
Vimentin	+	+	+	+	+
EMA	+	+	+	+	-
SMA	NA	+	+	NA	-
INI 1	-	-	-	-	NA
GFAP	-	-	-	+	+
NFP	NA	-	+	+	NA
S100	NA	+	-	NA	NA
CK:	-	NA	-	NA
CKAE1/AE3					+
CK7
CK20
Chromosome 22q deletion	NA	NA	NA	+	NA
Desmin	-	NA	-	NA	-
LCA	-	NA	-	NA	-
Ki67	NA	7.8%	NA	NA	>20%
Others (stain positive)	Neuron-specific enolase	NA	CD99	NA	CD138, CD68,
Others (stain negative)	CD99, Tdt, myeloperoxidase	NA	HMB45, CD34, CD31, CD10, PLAP, MelanA, MYOD1, myogenin, chromogranin, p63	NA	Synaptophysin, HMB45, CD117, CD79, CD30, Tdt, PLAP

CD: Cluster of differentiation; CK: Cytokeratin; EMA: Epithelial membrane antigen; GFAP: Glial fibrillary acidic protein; HMB: Human melanoma black; INI 1: Integrase interactor 1; LCA: Leukocyte common antigen; MYOD: Myoblast determination protein; NA: Not applicable; NFP: Neurofilament protein; PLAP: Placental alkaline phosphatase; SMA: Smooth muscle actin; Tdt: Terminal deoxynucleotidyl transferase.

Table 3 Imaging features of radiation-induced malignant rhabdoid tumour

MRI	Padua et al[1]	Kuge et al[2]	Gorayski et al[3]	Oliveira et al[4]	Our case
Oedema	Yes	No	Yes	Yes	No
Peripheral cyst	Yes	No	Yes	Yes	No
Calcification	Yes	No	Yes	Yes	No
Contrast enhancement	Heterogenous	Heterogenous	Heterogenous, band-like	Heterogenous, band-like	Heterogenous, band-like
T2 signal	NA	NA	Hyperintense	NA	Hyperintense
FLAIR	NA	NA	Hyperintense	NA	Hyperintense
Leptomeningeal spread at first presentation	No	No	No	No	Yes
CT	Mix density: iso to hyperdense with foci of calcification and necrosis	Isodense	Mix density: isodense with foci of calcification and cyst	NA	Isodense to hyperdense

CT: Computed tomography; MRI: Magnetic resonance imaging; NA: Not available.

Table 4 Previous treatment details for radiation-induced malignant rhabdoid tumour

Case	Padua et al[1]	Kuge et al[2]	Gorayski et al[3]	Oliveira et al[4]	Our case
Latency period in yr	11	18	55	10	23
Age of previous RT in year	6	2	3	12	4
Dose of previous RT	NA	24 Gy	35 Gy	34 Gy	20 Gy
Reason for previous RT	Acute lymphoblastic leukaemia treatment: prophylactic cranial irradiation	Acute lymphoblastic leukaemia treatment: prophylactic cranial irradiation	Right ear sarcoma	Subtotal surgical removal of craniopharyngioma	Acute lymphoblastic leukaemia treatment: prophylactic cranial irradiation

RT: Radiation therapy.