Radiation-Induced Cervical Spinal Cord Cavernoma Following Head and Neck Radiotherapy: Case Report

Al-Jehani, Hosam; Najjar, Ahmad Al; Barnawi, Abdulwahid; Shédid, Daniel

doi:10.1055/s-0040-1709714

Cited by 2 publications

(16 citation statements)

References 4 publications

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“…CMs of the brain and spinal cord are rare and are thought to arise congenitally. 20 , 27 However, an increasing number of cases reporting the de novo formation in sporadic and familial cases presumes an acquired origin. 17 , 19 Evidence supporting this theory is provided by several reports of the de novo formation of CMs in response to irradiation of the central nervous system, spinal cord, or even the whole body.…”

Section: Discussionmentioning

confidence: 99%

“… 16 , 17 , 20 , 24 , 27 , 29 The extremely rare occurrence and multifactorial genesis of these lesions leave their natural history to date unknown. 20 , 27 …”

Section: Discussionmentioning

confidence: 99%

“…The first is that the CMs exist as radiographically occult lesions before radiation therapy. 17 , 19 , 20 , 27 The radiation-induced transformation ensues from long-term sequelae associated with radiation therapy, including tissue proliferation, remodeling, and hemorrhaging. 17 , 20 , 29 …”

Section: Discussionmentioning

confidence: 99%

“… 19 The key mediators of radiation-induced vascular alterations include vascular endothelial growth factor, basic fibroblast growth factor, and transforming growth factor α. 17 , 27 , 29 …”

Section: Discussionmentioning

confidence: 99%

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Radiation-induced cavernous malformations in the spine: patient series

Koester

Scherschinski

Srinivasan

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Radiation-induced spinal cord cavernous malformations (RISCCMs) are a rare subset of central nervous system lesions and are more clinically aggressive than congenital cavernous malformations (CMs). The authors assessed the characteristics and outcomes of patients with RISCCM at a single institution and systematically reviewed the pertinent literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. OBSERVATIONS Among the 146 spinal CMs at the authors’ institution, 3 RISCCMs were found. Symptom duration ranged from 0.1 to 8.5 months (mean [standard deviation], 3.2 [4.6] months), and latency ranged from 16 to 29 years (22.4 [9.6] years). All 3 RISCCMs were surgically treated with complete resection; 2 patients had stable outcomes, and 1 improved postoperatively. A review of 1240 articles revealed 20 patients with RISCCMs. Six of these patients were treated with resection, 13 were treated conservatively, and in 1 case, the treatment type was not stated. Five of the 6 patients treated surgically reported improvement postoperatively or at follow-up; 1 was stable, and none reported worsened outcomes. LESSONS RISCCMs are rare sequelae following radiation that inadvertently affect the spinal cord. Altogether, the frequency of stable and improved outcomes on follow-up suggests that resection could prevent further patient decline caused by symptoms of RISCCM. Therefore, surgical management should be considered primary therapy in patients presenting with RISCCMs.

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Section: Discussionmentioning

confidence: 99%

“… 16 , 17 , 20 , 24 , 27 , 29 The extremely rare occurrence and multifactorial genesis of these lesions leave their natural history to date unknown. 20 , 27 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Radiation-induced cavernous malformations in the spine: patient series

Koester

Scherschinski

Srinivasan

et al. 2023

Journal of Neurosurgery: Case Lessons

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“…The possible diagnoses before surgery included not only SIM of lung cancer but also delayed radiation necrosis or radiation-induced tumors, such as cavernous malformations. 13 , 14 ) The PLS approach from the left side was first selected to remove the tumor as it appeared to deviate slightly to the left side. However, the left PLS approach was not sufficient to expose the tumor.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Posterolateral Sulcus Approach for the Removal of Spinal Intramedullary Metastatic Adenocarcinoma: A Technical Case Report

Tsujino

Takai

Kanemitsu

et al. 2022

Neurol. Med. Chir.(Tokyo)

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Spinal intramedullary metastasis is an extremely rare event that occurs in advanced cancer. The surgical indications for spinal intramedullary metastasis are highly limited because of surgical difficulty and poor prognosis. In this technical case report, we present a rare case of spinal intramedullary metastasis from the lung that recurred late after local radiation to the spinal cord. The patient progressively experienced relapsed buttock pain and developed gait and urination disorders late after treatment for lung cancer. Imaging examinations suggested the recurrence of spinal intramedullary metastasis in the conus medullaris. Systemic examinations revealed no apparent recurrence in other organs, including the primary lung lesions. Gross total resection of the tumor within the conus medullaris was safely performed using the unilateral posterolateral (PLS) approach and by addition of the contralateral PLS approach. To the best of our knowledge, this is the first case in which a spinal intramedullary metastatic tumor was successfully removed using a bilateral PLS approach.

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Radiation-Induced Cervical Spinal Cord Cavernoma Following Head and Neck Radiotherapy: Case Report

Cited by 2 publications

References 4 publications

Radiation-induced cavernous malformations in the spine: patient series

Radiation-induced cavernous malformations in the spine: patient series

Bilateral Posterolateral Sulcus Approach for the Removal of Spinal Intramedullary Metastatic Adenocarcinoma: A Technical Case Report

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