Cargando…

Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report

INTRODUCTION: Demyelination can occur after brain radiotherapy in tissue adjacent to irradiated tumours. To date, no correlation has been found between conventional-dose radiotherapy and the development of multiple sclerosis, but radiotherapy could be a triggering factor among women with known multi...

Descripción completa

Detalles Bibliográficos
Autores principales: Guillemin, Florent, Biau, Julian, Conde, Sakahlé, Clavelou, Pierre, Dupic, Guillaume
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993054/
https://www.ncbi.nlm.nih.gov/pubmed/32021912
http://dx.doi.org/10.1016/j.ctro.2020.01.001
_version_ 1783492956740648960
author Guillemin, Florent
Biau, Julian
Conde, Sakahlé
Clavelou, Pierre
Dupic, Guillaume
author_facet Guillemin, Florent
Biau, Julian
Conde, Sakahlé
Clavelou, Pierre
Dupic, Guillaume
author_sort Guillemin, Florent
collection PubMed
description INTRODUCTION: Demyelination can occur after brain radiotherapy in tissue adjacent to irradiated tumours. To date, no correlation has been found between conventional-dose radiotherapy and the development of multiple sclerosis, but radiotherapy could be a triggering factor among women with known multiple sclerosis. To the best of our knowledge, this is the first well-documented case of this association with a dosimetric analysis. CASE PRESENTATION: The case we report here describes the development of multiple sclerosis in a 36-year-old woman without significant past medical history 3 months after the last session of fractionated stereotactic radiotherapy for a pituitary macroadenoma. Our dosimetric analysis suggests that all the multiple sclerosis lesions occurred in the brain regions irradiated with a mean biologically effective dose (BED(2)) of 33.9 Gy (27.3–49.6 Gy). CONCLUSION: Consequently special caution towards radiotherapy is required among patients with demyelinating illnesses or for 35–45-year-old women who are at risk. In addition, multiple sclerosis lesions can look like metastases. We should therefore keep differential diagnoses in mind in order not to make mistakes that would delay treatment.
format Online
Article
Text
id pubmed-6993054
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-69930542020-02-04 Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report Guillemin, Florent Biau, Julian Conde, Sakahlé Clavelou, Pierre Dupic, Guillaume Clin Transl Radiat Oncol Article INTRODUCTION: Demyelination can occur after brain radiotherapy in tissue adjacent to irradiated tumours. To date, no correlation has been found between conventional-dose radiotherapy and the development of multiple sclerosis, but radiotherapy could be a triggering factor among women with known multiple sclerosis. To the best of our knowledge, this is the first well-documented case of this association with a dosimetric analysis. CASE PRESENTATION: The case we report here describes the development of multiple sclerosis in a 36-year-old woman without significant past medical history 3 months after the last session of fractionated stereotactic radiotherapy for a pituitary macroadenoma. Our dosimetric analysis suggests that all the multiple sclerosis lesions occurred in the brain regions irradiated with a mean biologically effective dose (BED(2)) of 33.9 Gy (27.3–49.6 Gy). CONCLUSION: Consequently special caution towards radiotherapy is required among patients with demyelinating illnesses or for 35–45-year-old women who are at risk. In addition, multiple sclerosis lesions can look like metastases. We should therefore keep differential diagnoses in mind in order not to make mistakes that would delay treatment. Elsevier 2020-01-09 /pmc/articles/PMC6993054/ /pubmed/32021912 http://dx.doi.org/10.1016/j.ctro.2020.01.001 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Guillemin, Florent
Biau, Julian
Conde, Sakahlé
Clavelou, Pierre
Dupic, Guillaume
Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report
title Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report
title_full Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report
title_fullStr Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report
title_full_unstemmed Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report
title_short Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report
title_sort multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993054/
https://www.ncbi.nlm.nih.gov/pubmed/32021912
http://dx.doi.org/10.1016/j.ctro.2020.01.001
work_keys_str_mv AT guilleminflorent multiplesclerosisasdifferentialdiagnosisofradionecrosisforpostirradiationbrainlesionsacasereport
AT biaujulian multiplesclerosisasdifferentialdiagnosisofradionecrosisforpostirradiationbrainlesionsacasereport
AT condesakahle multiplesclerosisasdifferentialdiagnosisofradionecrosisforpostirradiationbrainlesionsacasereport
AT claveloupierre multiplesclerosisasdifferentialdiagnosisofradionecrosisforpostirradiationbrainlesionsacasereport
AT dupicguillaume multiplesclerosisasdifferentialdiagnosisofradionecrosisforpostirradiationbrainlesionsacasereport