P77 | A rare late side effect of radiotherapy
Year: 2025
Type: article
Study design: Case Report
Abstract: Premises: The number of patients undergoing radiotherapy (RT) for malignancies is increasing. While RT is an effective treatment, it is not without side effects.Description of the Case report: A 77-year-old man diagnosed with remitting diffuse large cell lymphoma affecting the right lung and the C6-T3 vertebral canal with spinal compression underwent decompressive laminectomy and RT in 2015. Eight years later, he observed the development of a retrocervical mass. Suspecting a disease relapse, he underwent an MRI revealing a 10 cm encapsulated formation imprinting the superficial muscle planes without infiltration. Biopsy was inconclusive. Soon after, the mass became painful and the patient developed fever, leading to admission to our ward. Blood tests showed anemia, acute kidney injury, and signs of infection, prompting initiation of antibiotic therapy. Subsequent MRI revealed a rupture of the mass capsule with the spread of infected content into the superficial layers. The patient underwent surgical resection involving neurosurgeons, plastic surgeons, and general surgeons, resulting in a successful recovery. Histological examination showed no evidence of neoplastic disease but revealed areas of ischemic and hemorrhagic necrosis with lymphovascular ectasia and lymphomonocytic infiltrate suggestive of radiation necrosis.Conclusions: Radiation necrosis is a rare late side effect of RT that clinicians should be aware of. It is due to the damage of healthy tissues and can occur up to 9 years post-exposure in 5-15% of irradiated patients.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413685142