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Lilian Sznajder, MD; Cyril Abrahams, MD; Dilys M. Parry, PhD; Theresa C. Gierlowski, MPM; Eileen Shore-Freedman, MS; Arthur B. Schneider, MD, PhD

Arch Intern Med. 1996;156(16):1873-1878.

Abstract
Objective
To determine the pattern of neural tumors (schwannomas, vestibular schwannomas [acoustic neuromas], and meningiomas) that developed in 3013 people who received radiation treatment with x-ray beam therapy for benign conditions of the head and neck area before their 16th birthday.

Methods
The surgical and pathology reports and pathology slides were reviewed for all neural tumors in the cohort. Patients with more than 1 neural tumor were compared with those with 1 neural tumor and those with no neural tumors.

Results
There were 7 patients with multiple neural tumors and 63 with single neural tumors. The distribution of tumors in these 2 groups differed. The group with multiple tumors had more spinal nerve root schwannomas, while the group with single tumors had more cranial nerve schwannomas. Six of the 7 patients did not meet the diagnostic criteria for neurofibromatosis type 2.

Conclusions
Our findings suggest that host factors that increase susceptibility to radiation may be involved in the development of the multiple neural tumors. Clinically, patients with multiple neural tumors who do not meet the diagnostic criteria for neurofibromatosis type 2 should be questioned about radiation exposure. If exposure is confirmed, then screening for other radiationrelated tumors should be initiated.

Arch Intern Med. 1996;156:1873-1878

Author Affiliations
From the Department of Medicine, University of Illinois at Chicago (Drs Sznajder and Schneider), the Department of Pathology, University of Chicago (Dr Abrahams), the Department of Medicine, Michael Reese Hospital, Chicago (Mss Gierlowski and Shore-Freedman and Dr Schneider), and the Genetic Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md (Dr Parry).

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