Radiation myelitis in a 5-year-old girl Journal Article

Authors: Antunes, N. L.; Wolden, S.; Souweidane, M. M.; Lis, E.; Rosenblum, M.; Steinherz, P. G.
Article Title: Radiation myelitis in a 5-year-old girl
Abstract: Myelopathy is an uncommon complication of radiotherapy, particularly in the pediatric age group. A 5-year-old girl with acute lymphoblastic leukemia developed a severe but transient radiculopathy after intrathecal administration of methotrexate and cytarabine for an isolated central nervous system relapse. Chemotherapy was then given through an intraventricular catheter. Owing to a second central nervous system recurrence, she was treated with craniospinal radiation. The whole brain down to the level of C2 received a dose of 2400 cGy. Two months after completion of radiation, the child developed a progressive tetraparesis, and magnetic resonance imaging revealed an enhancing lesion involving the medulla and upper cervical cord. A biopsy was consistent with a treatment-related necrotizing leukoencephalopathy. This case suggests that patients who develop neurologic dysfunction when treated with methotrexate can also be particularly susceptible to radiation-related injury.
Keywords: preschool child; child, preschool; cancer recurrence; case report; cancer radiotherapy; radiation dose; cytarabine; methotrexate; nuclear magnetic resonance imaging; magnetic resonance imaging; radiotherapy; dexamethasone; vincristine; pathology; radiation injury; necrosis; acute lymphoblastic leukemia; central nervous system tumor; radiation dosage; chronic disease; disease severity; chemically induced disorder; radiation injuries; asparaginase; glucocorticoid; biopsy technique; acute lymphocytic leukemia; hydrocortisone; disease predisposition; neurologic disease; immunosuppressive agents; leukoencephalopathy; immunosuppressive agent; skeletal muscle; muscle, skeletal; radiculopathy; myelitis; quadriplegia; leukemia, lymphocytic, acute; humans; human; female; priority journal; article; cervical spinal cord injury
Journal Title: Journal of Child Neurology
Volume: 17
Issue: 3
ISSN: 0883-0738
Publisher: Sage Publications, Inc.  
Date Published: 2002-03-01
Start Page: 217
End Page: 219
Language: English
PUBMED: 12026238
PROVIDER: scopus
DOI: 10.1177/088307380201700312
Notes: Export Date: 14 November 2014 -- Source: Scopus
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MSK Authors
  1. Eric Lis
    105 Lis
  2. Suzanne L Wolden
    427 Wolden
  3. Nuno L Antunes
    22 Antunes
  4. Marc Rosenblum
    257 Rosenblum
  5. Peter G Steinherz
    170 Steinherz