CASE REPORT   

Chirurgia 2017 February;30(1):25-7

DOI: 10.23736/S0394-9508.16.04588-5

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Cavernous malformation after radiation therapy for rhino-pharyngeal carcinoma

Marco AJELLO, Giulia PILLONI, Francesco ZENGA, Alessandro DUCATI, Diego GARBOSSA ✉

Neurosurgery Section, Department of Neuroscience, University of Turin, Turin, Italy

Some of the common complications occur after radiation therapy include persistent edema, radiation necrosis and cyst-neoplasia formation. Uncommon (unusual) complications such as radiation-induced cavernous malformations (CMs) have also been reported. We present one of the first patient who developed a radiation-induced CM following whole brain RT for a rhino-pharingeal carcinoma. A 10 years old patient, in the 1982, was treated for an undifferentiated oropharyngeal carcinoma with post-operative chemoterapy (A-driblastina, vincristina and endoxan) and radiotherapy. The MRI showed a good reduction of the mass untill 1997 and no recurrence. The last MRI in 1997 showed an aplasia of the right ACM. In 2011, 29 years after radiotherapy, a hypointense mass (1,8 cm) on T2 weighted magnetic resonance imaging developed in the right basal ganglia with no sign of bleeding; at the time of diagnosis the patient was asimptomatic, so the choise was to “scan and see”; the last MRI made in 2012 showed no change in cavernoma’s side and a recanalizzation of the right ACM. The development of the carotid stenosis 15 years after radiotherapy and 14 years before the diagnose of cavernoma, and the ricanalizzation year after, suggest us the potential role of vascular changes such as the narrowing of vassels in the pathophisiology of post-actinic cavernoma.

KEY WORDS: Post-actinic cavernoma - Carotid stenosis - Radiotherapy