Bilateral phrenic nerve dysfunction: a late complication of mantle radiation.
Neurologic complications from radiotherapy can be immediate or can occur many years after treatment. A known complication of radiotherapy to the supraclavicular and axillary lymph nodes is brachial plexus neuropathy. Although not a common injury, phrenic nerve dysfunction has been reported in association with radiation-induced brachial neuropathy. We describe a patient who developed asymmetric diaphragmatic weakness secondary to phrenic nerve paralysis 37 years after receiving mantle radiation for Hodgkin lymphoma. The patient did not have an associated brachial plexus neuropathy or a secondary malignancy involving the phrenic nerves. A radiation-induced injury was the most likely cause.
Avila
Edward K
EK
Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. vilae@mskcc.org
Goenka
Anuj
A
Fontenla
Sandra
S
D000293:Adolescent; D017668:Age of Onset; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D002278:Carcinoma in Situ / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D005260:Female; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000532:radiotherapy; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology; D010791:Phrenic Nerve / Q000503:physiopathology / Q000528:radiation effects*; D011832:Radiation Injuries / Q000150:complications* / Q000503:physiopathology; D011878:Radiotherapy / Q000009:adverse effects*