Mielopatia cervical após irradiação simulando tumor medular

Carvalho, Rui R. D.; Brandt, Reynaldo A.; Stecca, Jeronimo

doi:10.1590/S0004-282X1972000400010

Resumos

Os autores relatam um caso de paciente de 25 anos, masculino, submetido a radioterapia cervical por carcinoma indiferenciado do rinofaringe com metástases ganglionares. Seis meses depois desenvolveu tetraparesia progressiva com exames liquórico e mielográfico compatíveis com diagnóstico de tumor intramedular. O exame histopatológico revelou aspecto característico da mielopatia após irradiação.

The clinical and pathological studies of a post-radiation cervical myelopathy in a 25 year old male are reported. The patient had received 6000 r at the neck region for an undifferentiated carcinoma of the pharynx with metastasis to limph nodes. Six months latter progressive tetraparesis developed and myelography suggested intramedullary tumor. Post-mortem examination showed radiation cervical myelopathy.

Mielopatia cervical após irradiação simulando tumor medular

Radiation cervical myelopathy simulating spinal cord tumor: a case report

Rui R. D. Carvalho^I; Reynaldo A. Brandt^II; Jeronimo Stecca^III

^IDisciplina de Neurocirurgia e Departamento de Patologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo: Professor de Neurocirurgia

^IIDisciplina de Neurocirurgia e Departamento de Patologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo: Residente de Neurocirurgia

^IIIDisciplina de Neurocirurgia e Departamento de Patologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo: Professor-Assistente de Patologia

RESUMO

Os autores relatam um caso de paciente de 25 anos, masculino, submetido a radioterapia cervical por carcinoma indiferenciado do rinofaringe com metástases ganglionares. Seis meses depois desenvolveu tetraparesia progressiva com exames liquórico e mielográfico compatíveis com diagnóstico de tumor intramedular. O exame histopatológico revelou aspecto característico da mielopatia após irradiação.

SUMMARY

The clinical and pathological studies of a post-radiation cervical myelopathy in a 25 year old male are reported. The patient had received 6000 r at the neck region for an undifferentiated carcinoma of the pharynx with metastasis to limph nodes. Six months latter progressive tetraparesis developed and myelography suggested intramedullary tumor. Post-mortem examination showed radiation cervical myelopathy.

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Disciplina de Neurocirurgia Faculdade de Ciências Médicas da Santa Casa R. Cesário Motta Junior 112 01221 São Paulo, SP Brasil.

1. AHLBOM, H. E. Results of radiotherapy of hypopharyngeal cancer at the Radiumhemmet, Stockholm, 1930 to 1939. Acta Radiol. 22:155, 1941.
2. ALAJOUANINE, T.; LHERMITTE, F.; CAMBIER, J. & GAUTIER, J. C. Les lesions post-radiothérapiques tardives du systčme nerveux central. Rev. neurol. (Paris) 105:9, 1961.
3. ALPERS, B. J. & PANCOAST, H. K. The effect of irradiation on normal and neoplastic brain tissue. Amer. J. Cancer 17:7, 1933.
4. ARNOLD, A.; BAILEY, P.; HARVEY, R. A.; HAAS, L. L. & LAUGHLIN, J. S. Changes in the central nervous system following irradiation with 23-meV X-rays from betatron. Radiology 62:37, 1954.
5. ATKINS, H. L. & TRETTER, P. Time-dose considerations in radiation myelopathy. Acta radiol. (Ther. Phys. Biol.) 5:79, 1966.
6. BECLERE, A. Radiotherapy in tumors of the cerebrospinal cavity. Am. J. Phys. Therapy 3:540, 1927.
7. BODEN, G. Radiation myelitis of the cervical spinal cord. Br. J. Radiol. 21:464, 1948.
8. BODEN, G. Radiation myelitis of the brain-stem. J. Fac. Radiol. 2:79, 1950.
9. BOELLAARD, J. W. & JACOBY, W. Rötgenspätschäden des Gehirns. Acta Neurochir. 10:533, 1962.
10. CAIRNS, H. & FULTON, J. F. The action of radon on the spinal cord. Lancet 2:16, 1930.
11. CLEMENTE, C. D. & HOLST, E. A. Pathological changes in neurons, neuroglia, and blood-brain barrier induced by X-irradiation of heads of monkeys. Arch. Neurol. a. Psychiat. 71:67, 1954.
12. CROMPTON, M. R. & LAYTON, D. D. Delayed radionecrosis of the brain following therapeutic X-radiation of the pituitary. Brain 84:85, 1961.
13. DAVIDOFF, L. M.; DYKE, C. G.; ELSBERG, C. A. & TARLOV, I. M. The effect of radiation applied directly to the brain and spinal cord. Radiology 31:451, 1938.
14. DUGGER, G. S.; STRATFORD, J. G. & BOUCHARD, J. Necrosis of the brain following roentgen irradiation. Am. J. Roentgenol. 72:953, 1954.
15. EYSTER, E. F. & WILSON, C. B. Radiation myelopathy. J. Neurosurg. 32:414, 1970.
16. ITABASHI, H. H.; BEBIN, J. & DeJONG, R. N. Postirradiation cervical myelopathy. Neurology (Minneapolis) 7:844, 1957.
17. KRAMER, S. The hazards of therapeutic irradiation of the central nervous system. Clin. Neurosurg. 15:301, 1968.
18. LAMPERT, P. W. & DAVIS. R. L. Delayed effects of radiation on the human central nervous system: early and late delayed reactions. Neurology (Minneapolis) 14:912, 1964.
19. LOWENBERG-SCHAREMBERG, K. & BASSET, R. C. Amyloid degeneration of the human brain following X-ray therapy. J. Neuropath. & Exper. Neurol. 9:94, 1950.
20. MC LAURIN, R. L.; BAILEY, O. T.; HARSH, G. R. & INGRAHAM, F. D. The effects of gamma and roentgen radiation of the intact spinal cord of the monkey. Am. J. Roentg. 73:827, 1955.
21. MALAMUD, N.; BOLDREY, E. B.; WELCH, W. K. & FADELL, E. J. Necrosis of brain and spinal cord following X-ray therapy. J. Neurosurg. 11:353, 1954.
22. MARBURG, O.; REZEK, R. P. & FLEMING, R. M. Changes after treatment of an unprotected brain with large doses of roentgen radiation. Am. J. Roentg. 53:171, 1945.
23. PALLIS, C. A.; LEWIS, S. & MORGAN, R. L. Radiation myelopathy. Brain 84:460, 1961.
24. PALMER, J. J. Radiation myelopathy. Brain 95:109, 1972.
25. PECK Jr., F. C. & Mc GOVERN, E. R. Radiation necrosis of the brain in acromegaly. J. Neurosurg. 25:536, 1966.
26. PEYTON, W. T. Effect of radium on the spinal cord. Am. J. Cancer 20:558, 1934.
27. PLUM, F. Myelitis and myelopathy. InClinical Neurology, Edited by A. B. Baker. Hoeber Medical Division, Harper & Row Publishers Inc., New York, 1955.
28. RIDER, W. D. Radiation damage to the brain: a new syndrome. J. Can. Ass. Radiol. 14:67, 1963.
29. SCHOLZ, W. & HSU, Y. K. Late damage from roentgen irradiation of the human brain. Arch. Neurol, a. Psychiat. 40:928, 1938.
30. SMITHERS, D. W.; CLARKSON, J. R. & STRONG, J. A. The roentgen treatment of cancer of the esophagus. Am. J. Roentg. 49:606, 1943.
31. STEVENSON, L D. & ECKHARDT, R. E. Myelomalacia of the cervical portion of the spinal cord, probably the result of roentgen therapy. Archs. Pathol. 39:109, 1945.
32. VAN BOGAERT, L. & HERMANNE, J. Aspects cliniques et pathologiques des radionécroses cérébrales chez l'homme. Ann. Med. 49:14, 1948.
33. WACHOWSKI, T. J. & CHENAULT, H. Degenerative effects of large doses of roentgen rays on the human brain. Radiology 45:227, 1945.
34. WARREN, S. Effects of radiation on normal tissues. Arch. Path. 35:127, 1943.
35. WARREN, S. The hystopathology of radiation lesions. Physiol. Rev. 24: 225, 1944.
36. ZEMAN, W. Pathogenesis of radiolesions in the mature central nervous system. Proc. Fifth Int. Con. Neuropath., Amsterdam, 1965. Edited by F. Luthy & A. Bischoff, Excerpta Med. Foundation.
37. ZÜLCH, K. J. Über die Strahlensensibiliäát der Hirngschwülste und die sogenannte Strahlen-Spätnekrose des Hirns. Deutsch. Med. Wschr. 85:293, 1960.

Datas de Publicação

Publicação nesta coleção
18 Abr 2013
Data do Fascículo
Dez 1972

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. AHLBOM, H. E. Results of radiotherapy of hypopharyngeal cancer at the Radiumhemmet, Stockholm, 1930 to 1939. Acta Radiol. 22:155, 1941.

[2] 2. ALAJOUANINE, T.; LHERMITTE, F.; CAMBIER, J. & GAUTIER, J. C. Les lesions post-radiothérapiques tardives du systčme nerveux central. Rev. neurol. (Paris) 105:9, 1961.

[3] 3. ALPERS, B. J. & PANCOAST, H. K. The effect of irradiation on normal and neoplastic brain tissue. Amer. J. Cancer 17:7, 1933.

[4] 4. ARNOLD, A.; BAILEY, P.; HARVEY, R. A.; HAAS, L. L. & LAUGHLIN, J. S. Changes in the central nervous system following irradiation with 23-meV X-rays from betatron. Radiology 62:37, 1954.

[5] 5. ATKINS, H. L. & TRETTER, P. Time-dose considerations in radiation myelopathy. Acta radiol. (Ther. Phys. Biol.) 5:79, 1966.

[6] 6. BECLERE, A. Radiotherapy in tumors of the cerebrospinal cavity. Am. J. Phys. Therapy 3:540, 1927.

[7] 7. BODEN, G. Radiation myelitis of the cervical spinal cord. Br. J. Radiol. 21:464, 1948.

[8] 8. BODEN, G. Radiation myelitis of the brain-stem. J. Fac. Radiol. 2:79, 1950.

[9] 9. BOELLAARD, J. W. & JACOBY, W. Rötgenspätschäden des Gehirns. Acta Neurochir. 10:533, 1962.

[10] 10. CAIRNS, H. & FULTON, J. F. The action of radon on the spinal cord. Lancet 2:16, 1930.

[11] 11. CLEMENTE, C. D. & HOLST, E. A. Pathological changes in neurons, neuroglia, and blood-brain barrier induced by X-irradiation of heads of monkeys. Arch. Neurol. a. Psychiat. 71:67, 1954.

[12] 12. CROMPTON, M. R. & LAYTON, D. D. Delayed radionecrosis of the brain following therapeutic X-radiation of the pituitary. Brain 84:85, 1961.

[13] 13. DAVIDOFF, L. M.; DYKE, C. G.; ELSBERG, C. A. & TARLOV, I. M. The effect of radiation applied directly to the brain and spinal cord. Radiology 31:451, 1938.

[14] 14. DUGGER, G. S.; STRATFORD, J. G. & BOUCHARD, J. Necrosis of the brain following roentgen irradiation. Am. J. Roentgenol. 72:953, 1954.

[15] 15. EYSTER, E. F. & WILSON, C. B. Radiation myelopathy. J. Neurosurg. 32:414, 1970.

[16] 16. ITABASHI, H. H.; BEBIN, J. & DeJONG, R. N. Postirradiation cervical myelopathy. Neurology (Minneapolis) 7:844, 1957.

[17] 17. KRAMER, S. The hazards of therapeutic irradiation of the central nervous system. Clin. Neurosurg. 15:301, 1968.

[18] 18. LAMPERT, P. W. & DAVIS. R. L. Delayed effects of radiation on the human central nervous system: early and late delayed reactions. Neurology (Minneapolis) 14:912, 1964.

[19] 19. LOWENBERG-SCHAREMBERG, K. & BASSET, R. C. Amyloid degeneration of the human brain following X-ray therapy. J. Neuropath. & Exper. Neurol. 9:94, 1950.

[20] 20. MC LAURIN, R. L.; BAILEY, O. T.; HARSH, G. R. & INGRAHAM, F. D. The effects of gamma and roentgen radiation of the intact spinal cord of the monkey. Am. J. Roentg. 73:827, 1955.

[21] 21. MALAMUD, N.; BOLDREY, E. B.; WELCH, W. K. & FADELL, E. J. Necrosis of brain and spinal cord following X-ray therapy. J. Neurosurg. 11:353, 1954.

[22] 22. MARBURG, O.; REZEK, R. P. & FLEMING, R. M. Changes after treatment of an unprotected brain with large doses of roentgen radiation. Am. J. Roentg. 53:171, 1945.

[23] 23. PALLIS, C. A.; LEWIS, S. & MORGAN, R. L. Radiation myelopathy. Brain 84:460, 1961.

[24] 24. PALMER, J. J. Radiation myelopathy. Brain 95:109, 1972.

[25] 25. PECK Jr., F. C. & Mc GOVERN, E. R. Radiation necrosis of the brain in acromegaly. J. Neurosurg. 25:536, 1966.

[26] 26. PEYTON, W. T. Effect of radium on the spinal cord. Am. J. Cancer 20:558, 1934.

[27] 27. PLUM, F. Myelitis and myelopathy. InClinical Neurology, Edited by A. B. Baker. Hoeber Medical Division, Harper & Row Publishers Inc., New York, 1955.

[28] 28. RIDER, W. D. Radiation damage to the brain: a new syndrome. J. Can. Ass. Radiol. 14:67, 1963.

[29] 29. SCHOLZ, W. & HSU, Y. K. Late damage from roentgen irradiation of the human brain. Arch. Neurol, a. Psychiat. 40:928, 1938.

[30] 30. SMITHERS, D. W.; CLARKSON, J. R. & STRONG, J. A. The roentgen treatment of cancer of the esophagus. Am. J. Roentg. 49:606, 1943.

[31] 31. STEVENSON, L D. & ECKHARDT, R. E. Myelomalacia of the cervical portion of the spinal cord, probably the result of roentgen therapy. Archs. Pathol. 39:109, 1945.

[32] 32. VAN BOGAERT, L. & HERMANNE, J. Aspects cliniques et pathologiques des radionécroses cérébrales chez l'homme. Ann. Med. 49:14, 1948.

[33] 33. WACHOWSKI, T. J. & CHENAULT, H. Degenerative effects of large doses of roentgen rays on the human brain. Radiology 45:227, 1945.

[34] 34. WARREN, S. Effects of radiation on normal tissues. Arch. Path. 35:127, 1943.

[35] 35. WARREN, S. The hystopathology of radiation lesions. Physiol. Rev. 24: 225, 1944.

[36] 36. ZEMAN, W. Pathogenesis of radiolesions in the mature central nervous system. Proc. Fifth Int. Con. Neuropath., Amsterdam, 1965. Edited by F. Luthy & A. Bischoff, Excerpta Med. Foundation.

[37] 37. ZÜLCH, K. J. Über die Strahlensensibiliäát der Hirngschwülste und die sogenannte Strahlen-Spätnekrose des Hirns. Deutsch. Med. Wschr. 85:293, 1960.