BACKGROUND: Secondary malignant neoplasms (SMN) in CNS tumor survivors has 
become problem of increasing concern over the last 20 years. These tumors 
usually occur in a different site from the primary brain tumor several years 
after treatment.
CASE REPORT: We report secondary cranial malignant neoplasms in three patients 
who were treated with irradiation and chemotherapy for their primary brain 
tumors. The first case is a male survivor of an orbital rhabdomyosarcoma who 
developed a meningioma 8 years later. The other two cases are female survivors 
of ependymomas who were irradiated at the age of 3 and developed secondary 
gliomas 8 and 17 years after therapy respectively.
CONCLUSION: Patients carry a risk of developing SMNs many years later since 
irradiation is still an important part of the treatment. An SMN may have a 
benign course, as in meningioma, or be a dilemma for the patient, as in 
glioblastoma.