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Published on: July 28, 2013

Atypical diffusion-restricted lesion in 5-Fluorouracil encephalopathy

W-W Lee1, J-S Kim, K R Son

  • 1Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.

AJNR. American Journal of Neuroradiology
|March 10, 2012
PubMed

Insights

5-Fluorouracil (5-FU) chemotherapy can cause central nervous system toxicity. This case highlights an unusual, reversible brain lesion in a gastric cancer patient, impacting areas beyond typical 5-FU encephalopathy.

Area of Science:

  • Neuro-oncology
  • Radiology
  • Medical Chemistry

Background:

  • 5-Fluorouracil (5-FU) is a common chemotherapy agent.
  • Central nervous system (CNS) toxicity is a known side effect of 5-FU.
  • Typical MR imaging findings of 5-FU encephalopathy involve deep cerebral white matter and corpus callosum lesions.

Observation:

  • A gastric cancer patient presented with symptoms of CNS toxicity.
  • MR imaging revealed atypical, reversible diffusion-restricted lesions.
  • Lesions were observed in the bilateral basal ganglia, thalami, and parasagittal frontal cortex.

Findings:

  • The observed lesions were atypical for 5-FU encephalopathy.
  • Diffusion and T2-weighted imaging demonstrated the characteristic involvement of basal ganglia, thalami, and frontal cortex.
  • The diffusion-restricted lesions showed reversibility, suggesting a dynamic process.

Implications:

  • This case expands the understanding of 5-FU-induced neurotoxicity.
  • It highlights the importance of considering atypical patterns in MR imaging for 5-FU encephalopathy.
  • Recognizing reversible diffusion-restricted lesions may aid in timely diagnosis and management of chemotherapy-related CNS effects.

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