Secondary intracranial neoplasms exhibiting features of astrocytoma and neuroblastoma in 2 children treated for acute lymphoblastic leukemia: report of 2 cases

With the advent of more aggressive antineoplastic combination chemotherapies, agents with fewer adverse effects, prophylactic central nervous system radiation treatments, and more efficacious antibiotics, the number of childhood cancer survivors is continually increasing. These patients place a new responsibility on clinicians; systematic follow-up with effective intervention is necessary to reduce the consequences of the treatments themselves. We report 2 patients who were diagnosed with pre-B-cell acute lymphoblastic leukemia and later presented with intracranial malignancies. Both patients were treated with radiation and with similar chemotherapeutic regimens. Each patient was in remission for leukemia at the time of diagnosis of the second malignancy. The possible causes of the brain tumors in association with acute lymphoblastic leukemia are discussed.