1/22. Endovascular repair of radiation-induced bilateral common carotid artery stenosis and pseudoaneurysms: a case report.BACKGROUND: Radiation-induced damage to small and medium-sized vessels has been observed in both animals and humans. Changes may appear in the immediate postradiation period or many years later. In this case, we report an unusual presentation of bilateral radiation-induced carotid artery stenoses associated with pseudoaneurysms, and a previously unreported application of a recently established treatment. CASE DESCRIPTION: A 72-year-old African-American male presented with recurrent right hemispheric transient ischemic attacks (TIA) and neck pain. Thirteen years previously, the patient had received radiation therapy for laryngeal carcinoma. Diagnostic carotid angiography demonstrated moderate radiation-induced bilateral carotid artery stenosis and associated common carotid pseudoaneurysms. The patient was treated with bilateral endovascular stents and electrolytically detachable coils in staged procedures. At his most recent follow-up, there is no evidence of re-stenosis and the patient remains asymptomatic. CONCLUSIONS: This case illustrates a novel and successful treatment for the endovascular repair of post-radiation bilateral carotid artery stenosis and pseudoaneurysms. In our practice, we have seen three such cases of radiation-induced vasculopathy. Therefore, patients with a previous history of radiation therapy for head and neck neoplasms merit cautious monitoring and judicious use of stents and secondary coils, when necessary.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/22. Radiation-induced cancers of the pharynx and larynx: a study of five clinical cases.Radiation-induced cancer, a rare clinical entity, is often difficult to diagnose and manage. This study reports a series of five cases of radiocarcinogenesis of the pharynx and/or larynx that developed after external radiotherapy. The primary lesion was diagnosed at a mean age of 50 years ( /-12.9) and the radiation-induced cancer at a mean age of 59 years ( /-13.1), giving a latent period of 9 years ( /-3.7). Analysis of gammagraphic records indicated that four of the patients had developed a secondary tumour in the penumbra of irradiation fields. In these zones, the delivered dose was between 20 and 80% of the prescribed dose, corresponding to an estimated cumulative mean dose of 14.1-56.3 Gy. These results are compared with data in the literature to determine the diagnostic criteria for radiation-induced cancer, possible predisposition (genetic or acquired) and the dose effect.- - - - - - - - - - ranking = 0.28571428571429keywords = radiation-induced (Clic here for more details about this article) |
3/22. Complication of esophageal self-dilation for radiation-induced hypopharyngeal stenosis.We present an unusual case of hypopharyngeal stenosis, secondary to radiation therapy for laryngeal squamous cell carcinoma, complicated by repeated inadvertent passage of a Maloney dilator through the larynx into the right mainstem bronchus during self-dilation. A brief review of esophageal/hypopharyngeal stenosis and management alternatives is presented. Self-dilation is presented as a therapeutic method for recurrent stenosis of the hypopharynx and esophagus. Recognition and avoidance of this complication is discussed.- - - - - - - - - - ranking = 0.57142857142857keywords = radiation-induced (Clic here for more details about this article) |
4/22. Radiation-induced laryngeal angiosarcoma after cervical tuberculosis and squamous cell carcinoma: case report and review of the literature.Primary laryngeal angiosarcoma (LA) is quite rare with only 13 cases reported in English literature to date. A case of LA after radiation therapy for tuberculosis and squamous cell carcinoma is reported. A 70-year-old woman had a history of radiation therapy for left cervical tuberculosis at the age of 28. At 60 years of age a squamous cell carcinoma of the larynx was found and chemotherapy and radiotherapy, consisting of a total dose of 68.4 Gy, were administered. At the age of 68, recurrent squamous cell carcinoma was suspected from several biopsies, and a total laryngectomy with right thyroidectomy was performed. The tumor cells formed vascular spaces and expressed some endothelial markers, such as CD34, CD31, and ulex europaeus agglutinin I, but no epithelial markers, such as cytokeratins or epithelial membrane antigen. No residual squamous cell carcinoma was found. In the present case, it was suspected that irradiation to the larynx for cervical tuberculosis and squamous cell carcinoma induced angiosarcoma. The patient was still alive despite multiple skin and soft tissue metastasis 3 years and 6 months after the radical operation. Distinction of postirradiation angiosarcoma from pseudoangiosarcomatous carcinoma seems difficult but is important because irradiation is not effective and an initial radical surgery is the only effective treatment. Although irradiation is a common treatment for laryngeal squamous cell carcinoma, this is only the second case of radiation-induced LA in English literature.- - - - - - - - - - ranking = 0.14285714285714keywords = radiation-induced (Clic here for more details about this article) |
5/22. Cervical dystonia mimicking dropped-head syndrome after radiotherapy for laryngeal carcinoma.We report a case of cervical dystonia mimicking dropped-head syndrome (DHS) in a 57-year-old man treated for laryngeal carcinoma by radiotherapy (74.4 Gy) 3 months before. Cervical computerized tomographic scan and magnetic resonance imaging (MRI) did not find any muscle fat changes but found a high-intensity signal on T2 weighted images in the cervical spinal cord. Clinical and electromyographic findings were consistent with cervical dystonia. A trapezius biopsy was normal. Spontaneous remission of the dystonia was observed for 1 month whereas the laryngeal carcinoma progressed. The link between cervical dystonia and radiotherapy might be acute radiation-induced damage to the cervical spinal cord.- - - - - - - - - - ranking = 0.14285714285714keywords = radiation-induced (Clic here for more details about this article) |
6/22. Angiosarcoma of the larynx. Case report and review of the literature.Angiosarcoma of the larynx is a rare malignant tumour of vascular origin, accounting for less than 1% of all malignant tumours of the larynx. Angiosarcoma involves, in particular, the head and neck in areas such as the scalp and face. The causes are unknown, even if, in some cases, it is believed to be radiation-induced. The case is described of a patient with hypopharyngolaryngeal angiosarcoma, which became manifest with dysphagia, dysphonia and a palpable right latero-cervical mass about 7 cm in length. The patient underwent total pharyngolaryngectomy, right hemithyroidectomy, and bilateral neck dissection. Histological examination of the surgical specimen revealed a large haemorrhagic lesion involving the right pyriform sinus and homolateral hemilarynx. Right radical neck dissection revealed 9 metastatic lymph nodes, 1 of which with capsular invasion. Upon complete recovery the patient, underwent adjuvant post-operative radiotherapy. Six months later she is still alive with no clinical or radiological signs of disease. A careful review of the literature produced very few reports of such cases, only 6 of which in the last 30 years. survival rate is very low, even if feasible average can be advanced, in view of the paucity of the case reports. Histological diagnosis is not always straightforward, as this neoplasm may be misdiagnosed as other vascular tumours (Kaposi's sarcoma, haemangiopericytoma), as non-neoplastic lesions (granulomas secondary to intubation) and as poorly differentiated squamous cell carcinoma. Immunohistochemical evaluation by means of markers, such as vimentin and factor viii, offers a significant contribution to the diagnosis of angiosarcoma. The treatment of choice for laryngeal angiosarcoma is surgical excision, ample and radical, whenever possible, followed by adjuvant post-operative radiotherapy.- - - - - - - - - - ranking = 0.14285714285714keywords = radiation-induced (Clic here for more details about this article) |
7/22. Neutrophilic dermatosis of the hands: four new cases and review of the literature.BACKGROUND: Isolated or predominantly hand involvement in Sweet's syndrome, pyoderma gangrenosum, or pustular vasculitis is a rare presentation in the spectrum of neutrophilic dermatoses and is often associated with an occult malignancy or other systemic inflammatory disorder. When these disorders occur on the hands, they are often clinically indistinguishable, but they can sometimes be separated histologically by the presence of papillary dermal edema (Sweet's syndrome), ulceration and necrosis (pyoderma gangrenosum), or vasculitis (pustular vasculitis). These distinctions may be arbitrary, however, and reflect differences in the temporal course of the disease and in the degree of inflammation at the time of biopsy. methods: We report four cases of neutrophilic dermatosis affecting the hands and a review of the literature for similar cases. RESULTS: Of the four patients presented, two had associated carcinomas and one had myelodysplasia in transition to leukemia. The cutaneous symptoms preceded the finding of an occult malignancy. Thirty-two reported cases of neutrophilic dermatoses presenting on the hands showed clinicopathologic features similar to those in our series. Taken together, the mean age at diagnosis was 60.5 years, and 58% of the patients were female. Twenty-five per cent (nine patients) also had myelodysplasia or leukemia, 14% (five patients) ulcerative colitis, 6% (two patients) carcinoma, 6% (two patients) Crohn's disease, and 6% (two patients) seropositive arthritis. CONCLUSIONS: These cases illustrate the importance of recognizing that neutrophilic dermatoses may present uniquely or predominantly on the hands. This presentation is distinctive, and prompt diagnosis may prevent unnecessary medical or surgical therapy and may lead to the earlier diagnosis and treatment of an associated malignancy or other systemic disorder.- - - - - - - - - - ranking = 0.0004045529684433keywords = leukemia (Clic here for more details about this article) |
8/22. A case of granulocytic sarcoma during complete remission of acute myeloid leukemia with multiple masses involving the larynx and nasopharynx.A thirty-seven-year-old male patient presented with dysphagia and hoarseness six months after complete remission of acute myeloid leukemia (AML-M0), which had been treated with chemotherapy. physical examination revealed left vocal cord paralysis and involvement of the 9th, 10th, and 12th cranial nerves. Sagittal and axial magnetic resonance scans of the nasopharynx and neck showed a mass in the left retropharyngeal and perivertebral regions, 6x4 cm in size; another mass in the left vallecula, and infiltration of the right preepiglottic tissue by another mass of 2 cm. There was no bone marrow involvement. A diagnosis of granulocytic sarcoma without leukemia relapse was made and the FLAG-Ida regimen was administered, after which partial regression of the masses was observed. However, the patient died due to a pulmonary infection on the 17th day of chemotherapy.- - - - - - - - - - ranking = 0.0012136589053299keywords = leukemia (Clic here for more details about this article) |
9/22. Radiation-induced mandibular osteogenic sarcoma: report of a case and review of the literature.The case of a 56-year-old man with osteogenic sarcoma of the mandible diagnosed 7 years after radiotherapy treatment of a laryngeal cancer is reported. Surgery was the initial treatment. The progress was poor after local and pulmonary relapse, without response to chemotherapy treatment. Radiation-induced sarcomas are uncommon tumors that are diagnosed by meeting some diagnostic criteria. The mandible is a location very sensitive to radiation effects. The authors have found in the literature 30 cases of mandibular radiation-induced osteogenic sarcomas, most of them secondary to treatment of benign lesions, none of them secondary to treatment of a laryngeal cancer, as was seen in their case.- - - - - - - - - - ranking = 0.14285714285714keywords = radiation-induced (Clic here for more details about this article) |
10/22. Chronic myelogenous leukemia following radiotherapy and chemotherapy for non-Hodgkin lymphoma.We report here a women who developed chronic myelogenous leukemia (CML) after successful radiotherapy and chemotherapy for non-Hodgkin lymphoma. review of the literature indicates that exposure to ionizing radiation is associated with an increased risk of CML.- - - - - - - - - - ranking = 0.0010113824211083keywords = leukemia (Clic here for more details about this article) |
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