Fatal necrotizing encephalopathy complicating treatment of malignant gliomas with intra-arterial BCNU and irradiation: A pathological study Journal Article

  

Authors:	Rosenblum, M. K.; Delattre, J. Y.; Walker, R. W.; Shapiro, W. R.
Article Title:	Fatal necrotizing encephalopathy complicating treatment of malignant gliomas with intra-arterial BCNU and irradiation: A pathological study
Abstract:	We describe the neuropathologic findings at autopsy in six patients who developed a progressive encephalopathy complicating the treatment of malignant gliomas with combined intra-arterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and cerebral irradiation. Four brains were free of tumor and one contained a microscopic focus of residual glioma. In only one case was there evidence of tumor progression. A disseminated process characterized by miliary foci of necrosis with mineralizing axonopathy was present in all cases, restricted to the internal carotid distribution of the perfused hemisphere and involving primarily though not exclusively the white matter, which was diffusely and severely edematous. This was combined in 3 cases with a histologically dissimilar, massive necrotizing leukoencephalopathy indistinguishable from pure radionecrosis. Much of the toxicity of this therapy is mediated by vascular injury, but the disseminated necrotizing lesion probably reflects, at least in part, direct neural damage. © 1989 Kluwer Academic Publishers.
Keywords:	clinical article; side effect; combined modality therapy; neurotoxicity; glioma; brain neoplasms; computer assisted tomography; radiotherapy; necrosis; histology; carmustine; brain disease; brain diseases; intraarterial drug administration; infusions, intra-arterial; autopsy; brain edema; computer analysis; bcnu; encephalopathy; human; cerebral irradiation
Journal Title:	Journal of Neuro-Oncology
Volume:	7
Issue:	3
ISSN:	0167-594X
Publisher:	Springer
Date Published:	1989-09-01
Start Page:	269
End Page:	281
Language:	English
DOI:	10.1007/bf00172921
PUBMED:	2795121
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0024330370&doi=10.1007%2fBF00172921&partnerID=40&md5=384b5592ff14f9a9d1240ef933a47309
Notes:	Article -- Export Date: 14 April 2020 -- Source: Scopus

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