Cerebral radionecrosis with cystic degeneration following radiotherapy for nasal cavity squamous cell carcinoma: a case report.
A 31-year-old man with nasal cavity squamous cell carcinoma was treated in our hospital with two courses of radiotherapy (120 Gy total dose) followed by surgical tumor resection. Three years after the last irradiation, he developed seizures as well as changes in behavior and consciousness. Medical therapy with diphenylhydantoin (Dilantin) terminated the seizures. Dysphagia, unsteady gait, and right-side limb weakness developed 37 months after the onset of seizures. Magnetic resonance imaging showed a large, cystic mass in the left temporal lobe with left to right midline shift. Following craniotomy with decompression of the cystic mass, the patient improved clinically. No malignant cells were found in the specimen. No further progression of neurologic symptoms was noted after a 1-year follow-up. Cerebral radionecrosis is an uncommon late complication of radiotherapy and needs to be differentiated from tumor recurrence or metastasis if the irradiation field covers the cerebral region in patients with head and neck malignancies.
Hsu
Ying-Che
YC
Department of Otolaryngology, Kaohsiung Medical University, Kaohsiung, Taiwan. hsuyc1@pchome.com.tw
Ho
Kuen-Yao
KY
Kuo
Wen-Rei
WR
Wang
Ling-Feng
LF
Lee
Ka-Wo
KW
Huang
Shiuh-Lin
SL
D000328:Adult; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009336:Necrosis; D009669:Nose Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*