1/233. Delayed radionecrosis of the larynx.radiation has been used to treat carcinoma of the larynx for more than 70 years. Radionecrosis is a well-known complication of this modality when treating head and neck neoplasms. It has been described in the temporal bone, midface, mandible, and larynx. Laryngeal radionecrosis is manifested clinically by dysphagia, odynophagia, respiratory obstruction, hoarseness, and recurrent aspiration. The vast majority of patients who develop laryngeal radionecrosis present with these symptoms within 1 year of treatment; however, delayed presentations have been reported up to 25 years after radiotherapy. We present, in a retrospective case analysis, an unusual case of laryngeal radionecrosis in a patient who presented more than 50 years after treatment with radiotherapy for carcinoma of the larynx. The cases of delayed laryngeal necrosis in the literature are presented. This represents the longest interval between treatment and presentation in the literature. The details of the presentation, clinical course, and diagnostic imaging are discussed. The pathogenesis, clinical features, and treatment options for this rare complication are reviewed. Early stage (Chandler I and II) laryngeal radionecrosis may be treated conservatively and often observed. Late stage (Chandler III and IV) cases are medical emergencies, occasionally resulting in significant morbidity or mortality. Aggressive diagnostic and treatment measures must be implemented in these cases to improve outcome. This case represents the longest interval between initial treatment and presentation of osteoradionecrosis in the literature. A structured diagnostic and therapeutic approach is essential in managing this difficult problem.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/233. Pulsed dye laser treatment of telangiectasia after radiotherapy for breast carcinoma.Telangiectasia formed following exposure to X-ray irradiation have been reported to respond well to the pulsed dye laser system. We present the case of a 34-year-old woman with extensive post-radiotherapy skin telangiectasia of the chest wall and axilla who was treated with six sessions of pulsed dye laser treatment, with a considerable improvement in appearance. We recommend the pulsed dye laser as an option in the treatment of post-radiotherapy telangiectasia.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
3/233. Acute lower extremity paralysis following radiation therapy for cervical cancer.BACKGROUND: Acute lower extremity paralysis secondary to lumbosacral plexopathy is a rare but severe complication that may follow pelvic radiotherapy for cervical cancer. CASE: A 49-year-old female with newly diagnosed stage IIIB cervical cancer developed progressive bilateral lower extremity paralysis and pelvic pain only 10 weeks following completion of radiation therapy for cervical cancer with no evidence of metastasis or progression of disease. Her bladder and bowel function were not affected. Following extensive workup, the most likely etiology was presumed radiation-induced lumbosacral plexopathy. CONCLUSION: Although metastatic carcinoma is more commonly the reason for progressive lower extremity weakness with pelvic pain in women with advanced cervical cancer, radiation-induced lumbosacral plexopathy, a rare but devastating complication, may be the cause. diagnosis is by exclusion.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
4/233. dental caries after radiotherapy of the oral regions.Five cases of dental caries after radiation therapy of the oral regions for treatment of carcinomas are presented. The differences in clinical appearance and behavior between radiation caries and ordinary smooth-surface dental caries are described. The role of salivary gland irradiation and the resultant xerostomia in the development of these lesions is discussed. Some explanations are offered as to how these lesions develop in the light of current knowledge concerning plaque and the development of dental caries. Several measures that may be taken to reduce the incidence and severity of these lesions are suggested.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
5/233. Superior vena cava obstruction caused by radiation induced venous fibrosis.superior vena cava syndrome is most often caused by lung carcinoma. Two cases are described in whom venous obstruction in the superior mediastinum was caused by local vascular fibrosis due to radiotherapy five and seven years earlier. The development of radiation injury to greater vessels is discussed, together with the possibilities for treatment of superior vena cava syndrome.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
6/233. Postirradiation morphea of the breast presentation of two cases and review of the literature.The advent of radiation therapy as a common modality in the treatment and palliation of breast cancer has led to the observation of morphea developing months to years after supervoltage radiation therapy, in and around the site of treatment. We report 2 new cases of morphea at the site of previous supervoltage radiation therapy for breast cancer. The time period between irradiation and onset of morphea in our 2 patients were an atypically long 6.5 years and 32 years, the latter being the longest reported such interval. With conservative treatment, the inflammatory component of the lesions resolved over an approximately 1-year period, leaving residual sclerosis. These patients are compared to those previously reported in the medical literature so as to summarize the range of clinical presentation and course. Recognition of postirradiation morphea is important in distinguishing it from infectious cellulitis, recurrent carcinoma, metastatic carcinoma or development of a second primary carcinoma. copyright (R) 2000 S.Karger AG, Basel- - - - - - - - - - ranking = 1.5keywords = carcinoma (Clic here for more details about this article) |
7/233. The role of radiation in delayed hearing loss in nasopharyngeal carcinoma.Although radiation damage to the inner ear can be induced experimentally in animals, its incidence in humans as a complication of therapy for nasopharyngeal carcinoma (NPC) remains a matter of conjecture due to inadequate histological validation. A case of advanced NPC with a mixed conductive and neurosensory hearing loss is presented that at necropsy showed tumour invasion of the VIIIth cranial nerve in the internal auditory meatus with associated infection. The architecture of the organ of corti was well-preserved despite heavy doses of radiation but degeneration, the cause of which could not be substantiated, was present in the auditory nerve pathway. A diagnosis of radiation damage to the end-organ of hearing in the absence of supporting histological evidence should be made with caution.- - - - - - - - - - ranking = 2.5keywords = carcinoma (Clic here for more details about this article) |
8/233. Aortoesophageal fistula-relief of massive hematemesis with an endovascular stent-graft.A 59-year-old man with an esophageal carcinoma developed massive hematemesis due to aortoesophageal fistula after irradiation therapy reached 58 Gy. Emergent treatment with an endovascular stent-graft was successfully performed and the patient followed an uneventful course until he died of pneumonia 4.5 months later, which was caused by a tracheoesophageal fistula. Stent-graft repair is a safe and effective method to treat aortoesophageal fistula and may be an alternative to surgical resection.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
9/233. radiation-induced heart disease.A 45-year old woman underwent a radical mastectomy in 1965 for carcinoma of the left breast with metastasis in the left axillar lymph nodes. Fifty per cent of the heart received 4,000 rads during post-operative x-ray therapy. Patient developed radiopneumonia and symptoms of acute pericarditis in 1967. Constrictive pericarditis developed gradually from 1972 on. A pericardiectomy was performed in June 1974 and a thickened pericardium could be removed. light and electron microscopic examination of a surgical biopsy of the left ventricular epi-myocardium revealed epicardial fibrosis, interstitial fibrosis of the myocardium and perivascular fibrosis. The diagnosis of post-radiation pericarditis was made. The myocardial involvement may be responsible for the subsequent clinical course.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
10/233. Cranial neuropathy following curative chemotherapy and radiotherapy for carcinoma of the nasopharynx.Cranial nerve damage following head and neck radiotherapy is an unusual event. Cranial neuropathy following concurrent chemotherapy and radiotherapy is unreported. The authors report a case of a 54-year-old man treated with curative chemotherapy and radiotherapy for a stage III nasopharyngeal carcinoma who developed an unilateral hypoglossal nerve palsy five years after therapy. Follow-up examination and magnetic resonance imaging (MRI) show no evidence of recurrent disease. hypoglossal nerve injury occurring after head and neck radiotherapy is an indirect effect due to progressive soft tissue fibrosis and loss of vascularity. This process develops over years leading to nerve entrapment and permanent damage. Cranial nerve palsies, including damage to the hypoglossal nerve, can develop years after therapy with no evidence of tumour recurrence. Chemotherapy and radiotherapy have improved progression-free and overall survival in advanced nasopharyngeal cancer. As more patients achieve long-term tumour control following chemotherapy and radiotherapy, we must be cognizant of potential late injury to cranial nerves.- - - - - - - - - - ranking = 2.5keywords = carcinoma (Clic here for more details about this article) |
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