Posterior Reversible Encephalopathy Syndrome During Combined Modality Therapy for Head and Neck Squamous Cell Carcinoma.
OBJECTIVE
Posterior reversible encephalopathy syndrome (PRES) is a rare and acute disease with central nervous system symptoms. Without appropriate therapy, patients may exhibit a poor prognosis. PRES should be recognized as a possible problem during therapy for head and neck squamous cell carcinoma (HNSCC).


METHODS
A 56-year-old female developed PRES during combined modality therapy for HNSCC. On the fourth day after surgery and following chemoradiotherapy, PRES developed with a sudden visual disorder, followed by headache located at the back of the head and convulsions accompanied by impaired consciousness. We diagnosed PRES based on the clinical manifestations and magnetic resonance imaging data.


RESULTS
The patient recovered from PRES by appropriate treatment.


CONCLUSIONS
This is the first case report of PRES developed during treatment for HNSCC. Masked by other cerebrovascular disorders, more cases of PRES could exist than usually expected; therefore, we should consider PRES as a differential diagnosis for central nervous system disorders developing during high-intensity therapy.
Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan hayatenn@gmail.com.
Takahiro
T
Wakasaki
Department of Cerebrovascular Medicine, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
Seiji
S
Gotoh
Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
Eri
E
Tomonobe
Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
Takenao
T
Mihara
Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
Junichi
J
Fukushima
D001921:Brain / Q000000981:diagnostic imaging*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D038524:Diffusion Magnetic Resonance Imaging; D004947:Esophagus / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D007825:Laryngectomy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D037981:Neck Dissection; D010611:Pharyngectomy; D054038:Posterior Leukoencephalopathy Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D019651:Plastic Surgery Procedures; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed
chemoradiotherapy; combined modality therapy; head and neck squamous cell carcinoma; posterior reversible encephalopathy syndrome; reversible posterior leukoencephalopathy syndrome