Arteritis and brachial plexus neuropathy as delayed complications of radiation therapy.
Radiation-induced arteritis of large vessels and brachial plexus neuropathy are uncommon delayed complications of local radiation therapy. We describe a 66-year-old woman with right arm discomfort, weakness, and acrocyanosis that developed 21 years after local radiation for breast adenocarcinoma. Arteriography revealed arteritis, with ulcerated plaque formation at the subclavian-axillary artery junction, consistent with radiation-induced disease, and diffuse irregularity of the axillary artery. Electromyography showed a chronic brachial plexopathy. The patient's acrocyanosis, thought to be due to digital embolization from her vascular disease, improved with antiplatelet therapy. The concurrent combination of radiation-induced arteritis and brachial plexopathy is uncommon but should be considered in patients presenting with upper extremity pain or weakness after radiation therapy.
Rubin
D I
DI
Division of Clinical Neurophysiology, Mayo Clinic, Rochester, Minn 55905, USA. rubin.devon@mayo.edu
Schomberg
P J
PJ
Shepherd
R F
RF
Panneton
J M
JM
D000230:Adenocarcinoma / Q000532:radiotherapy; D000368:Aged; D001027:Aortography; D001167:Arteritis / Q000000981:diagnostic imaging / Q000209:etiology*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000528:radiation effects*; D020516:Brachial Plexus Neuropathies / Q000000981:diagnostic imaging / Q000209:etiology*; D001943:Breast Neoplasms / Q000532:radiotherapy; D005260:Female; D006801:Humans; D011878:Radiotherapy / Q000009:adverse effects*; D013997:Time Factors