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Post-irradiation polyradiculopathy mimics leptomeningeal tumor on MRI
Amie W Hsia1, Jonathan S Katz, Steven L Hancock
1Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94304-0117, USA. ahsia@stanford.edu
Abstract:
Three patients with a remote history of Hodgkin's disease treated with total or subtotal lymphoid radiation 17 to 24 years earlier developed lumbosacral polyradiculopathy associated with nodular meningeal enhancement of the conus medullaris and cauda equina on MRI. None had evidence of recurrent Hodgkin's disease or second malignancy, and the MRI findings may be sequelae of radiation therapy.
Insights
Radiation therapy for Hodgkin's disease may cause delayed neurological issues. MRI revealed lumbosacral polyradiculopathy and meningeal enhancement in patients years after treatment, likely due to radiation sequelae.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Hodgkin's disease is a cancer of the lymphatic system.
- Radiation therapy is a common treatment for Hodgkin's disease.
- Long-term side effects of radiation therapy can occur years after treatment.
Observation:
- Three patients with a history of Hodgkin's disease developed lumbosacral polyradiculopathy.
- These patients had received total or subtotal lymphoid radiation 17 to 24 years prior.
- Magnetic resonance imaging (MRI) showed nodular meningeal enhancement of the conus medullaris and cauda equina.
Findings:
- The patients had no evidence of recurrent Hodgkin's disease.
- No second malignancy was detected in the patients.
- MRI findings were consistent with radiation therapy sequelae.
Implications:
- Radiation-induced neurological complications can manifest decades after treatment.
- Lumbosacral polyradiculopathy and meningeal enhancement may be late effects of lymphoid radiation.
- Further research is needed to understand and manage these delayed radiation effects.