1/213. Early-onset scleral necrosis after iodine I 125 plaque radiotherapy for ciliochoroidal melanoma.A 62-year-old man with a large ciliochoroidal melanoma developed early-onset scleral necrosis with tumor extrusion within 1 month of epibulbar iodine I 125 plaque radiotherapy. The eye was enucleated. Pathologic study revealed nonmicrobial scleral necrosis with extrusion of histologically intact and necrotic uveal melanoma cells. The patient has been followed up for 15 months without clinical recurrence. We discuss possible mechanisms to explain the early development of scleral necrosis after plaque therapy in this patient.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
2/213. radiation induced liver injury detected by particulate reticuloendothelial contrast agent.radiation induced liver injury detected by a particulate reticuloendothelial MR contrast agent is described in a patient with metastatic colon cancer. The irradiated hepatic parenchyma failed to darken after ferumoxide administration. This finding suggests that detection of metastatic disease after ferumoxide contrast agents may be impaired in patients who have previously received upper abdominal radiation treatment.- - - - - - - - - - ranking = 416.61651634184keywords = injury (Clic here for more details about this article) |
3/213. Photic maculopathy after pterygium excision.PURPOSE: To report a patient who developed photic maculopathy after pterygium removal. methods: A 27-year-old woman underwent pterygium removal with a conjunctival autograft after administration of retrobulbar anesthesia. A coaxial operating microscope was used, with an estimated retinal exposure of approximately 40 minutes. RESULTS: On the first postoperative day, the patient noted a paracentral scotoma. A fluorescein angiogram on the fourth postoperative day documented a phototoxic lesion in the macula. CONCLUSIONS: Phototoxic injury to the macula may occur after pterygium removal. Ophthalmologists should take precautions to minimize prolonged intense coaxial illumination of the retina while performing any ocular microsurgery.- - - - - - - - - - ranking = 83.323303268368keywords = injury (Clic here for more details about this article) |
4/213. 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 = 83.323303268368keywords = injury (Clic here for more details about this article) |
5/213. 'Full dose' reirradiation of human cervical spinal cord.With the progress of modern multimodality cancer treatment, retreatment of late recurrences or second tumors became more commonly encountered in management of patients with cancer. spinal cord retreatment with radiation is a common problem in this regard. Because radiation myelopathy may result in functional deficits, many oncologists are concerned about radiation-induced myelopathy when retreating tumors located within or immediately adjacent to the previous radiation portal. The treatment decision is complicated because it requires a pertinent assessment of prognostic factors with and without reirradiation, radiobiologic estimation of recovery of occult spinal cord damage from the previous treatment, as well as interactions because of multimodality treatment. Recent studies regarding reirradiation of spinal cord in animals using limb paralysis as an endpoint have shown substantial and almost complete recovery of spinal cord injury after a sufficient time after the initial radiotherapy. We report a case of "full" dose reirradiation of the entire cervical spinal cord in a patient who has not developed clinically detectable radiation-induced myelopathy on long-term follow-up of 17 years after the first radiotherapy and 5 years after the second radiotherapy.- - - - - - - - - - ranking = 83.323303268368keywords = injury (Clic here for more details about this article) |
6/213. radiation-induced blood-brain barrier damage in astrocytoma: relation to elevated gelatinase B and urokinase.Successful management of brain tumors prolongs life, raising the risk of delayed injury secondary to the treatment. radiation therapy, a mainstay of brain tumor treatment, can damage the cerebral blood vessels. Acutely a breakdown of the blood-brain barrier (BBB) may be seen, but fibrosis complicates radiation injury in the chronic phase. matrix metalloproteinases (MMPs) and plasminogen activators are two matrix-degrading proteolytic enzymes, which are induced by radiation. They disrupt the basal lamina around cerebral capillaries and open the BBB. We report a patient with an astrocytoma managed by partial resection and external beam irradiation to maximal tolerable doses. The patient later developed malignant brain edema shortly after stereotactic radiosurgery. Tissue obtained during surgical debulking to control the edema showed very high levels of gelatinase B (92 kDa type IV collagenase) and urokinase-type plasminogen activator (uPA). Tumor cells were absent from the biopsy and subsequent autopsy specimens, but necrosis with fibrosis of the blood vessels was seen. If abnormal matrix enzyme function participates in the expression of radiation injury, then inhibitors to such enzymes may provide one strategy for controlling cerebrovascular damage after therapeutic brain radiation.- - - - - - - - - - ranking = 249.9699098051keywords = injury (Clic here for more details about this article) |
7/213. Delayed radiation-induced bulbar palsy mimicking ALS.We describe a patient presenting with progressive bulbar dysfunction and spasticity that clinically mimicked amyotrophic lateral sclerosis (ALS). electromyography, however, showed no evidence of denervation and revealed a rare combination of peripheral and central myokymia. We feel that this pattern of myokymia represented a marker of neural injury from remote radiation therapy. nervous system disorders resulting from therapeutic radiation are described, and potential pathophysiologic mechanisms underlying myokymia are discussed.- - - - - - - - - - ranking = 83.323303268368keywords = injury (Clic here for more details about this article) |
8/213. 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 = 166.64660653674keywords = injury (Clic here for more details about this article) |
9/213. Fatal hemorrhage complicating carcinoma of the esophagus. Report of four cases.Four cases of esophageal carcinoma complicated by fatal hemorrhage are reported. All four patients had recently completed radiation therapy. An aortoesophageal fistula was present in two cases; fibrinoid necrosis of the esophageal arteries was present in the other two. The esophageal tumor was localized in two cases and had disappeared in one case. In one patient it had metastasized widely. Ninety-nine other reports of esophageal cancer and fatal hemorrhage are reviewed from the literature. Aortoesophageal fistula was the cause of hemorrhage in 78 cases. Occlusion of the vasa vasorum by thrombosis, inflammation, neoplastic cells or radiation injury appears to be the cause of aortic necrosis and fistula formation. Prompt surgical approach, if possible, should be used to control hemorrhage, as the primary tumor may be localized to the esophagus only.- - - - - - - - - - ranking = 83.323303268368keywords = injury (Clic here for more details about this article) |
10/213. radiation-induced pseudocarcinomatous proliferations of the urinary bladder: a report of 4 cases.Four cases of radiation cystitis that caused diagnostic difficulty because of an epithelial proliferation with architectural complexity and reactive cytologic atypia are described. The patients, 2 male, 2 female, were from 43 to 77 years of age. Two presented with hematuria. cystoscopy disclosed abnormalities in 3 patients. Microscopic examination showed irregularly shaped and arranged aggregates of epithelial cells in the upper and mid zones of the lamina propria. The cells, which typically showed at least mild, and sometimes severe, pleomorphism, were usually transitional, but squamous differentiation was seen focally in 3 cases. Ulceration of the overlying epithelium was present in all cases and was prominent and associated with conspicuous fibrin and hemorrhage in one of them. Edema of the lamina propria was present in 3 cases, whereas lamina propria fibrosis and chronic inflammation were present in all cases. The presence in all 4 cases of vascular ectasia and other changes characteristic of radiation injury, such as atypical fibroblasts, prompted investigation of the clinical history in 2 cases in which the pathologist was unaware that the patient had received radiation. Pseudocarcinomatous proliferations in the bladder caused by radiation injury have received limited attention in the literature. Our cases illustrate the potential diagnostic errors with which these lesions may be associated.- - - - - - - - - - ranking = 166.64660653674keywords = injury (Clic here for more details about this article) |
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