Radiation-induced meningiomas

37-year-old with meningiomas occurring after high-dose radiation for treatment of rhabdomyosarcoma at the age of 10 years. Transverse axial postcontrast T1-weighted MRI (A) shows a large right temporal extra-axial enhancing mass (asterisk) that extends into the right lateral orbit, sella, and prepontine cistern. There is a second, smaller dural-based mass along the greater wing of the left sphenoid bone (arrow). Histopathology of the right temporal mass was consistent with meningioma. 12 years earlier, axial FLAIR (B) and postcontrast T1-weighted (C) MRI demonstrated radiation-related white matter changes in the right temporal lobe (circle) and enhancing granulation tissue (thick arrow) in the area of the previous rhabdomyosarcoma.