Bilateral Basal Ganglia Calcification following Radiation Therapy for Brain Tumors

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Abstract
Three cases of bilateral basal ganglia calcification following radiation therapy for brain tumors were presented. In all of them the calcification was not seen on plain skull X-rays but only on CT scan. Case 1 was a 14 year-old boy who had a course of irradiation 5, 000 rads to the brain and 3, 300 rads to the spinal axis for cerebellar medulloblastoma at the age of 2 years. Case 2 was a 18 year-old girl who had a course of irradiation 5, 990 rads locally for craniopharyngioma at the age of 7 years. Case 3 was a 14 year-old girl who had a course of irradiation 5, 600 rads locally for suprasellar germinoma at the age of 9 years. The common features of these cases were: 1) radiation therapy was given for brain tumors in childhood, 2) more than 5 years had elapsed before calcification was seen, and 3) calcification was observed only on CT. Review of the literature revealed that 7 cases of similar calcification were previously reported. Slight disturbance of calcium metabolism was noted in both of our two cases who were examined in detail. It was suggested that subtle disturbance of calcium metabolism secondary to irradiation to the hypothalamus or directly to the parathyroid might play an important role in the pathogenesis of this disorder. It was expected that similar cases would increase keeping step with further improvement of CT machinery.

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