TITLE:
Radiation-Induced Spinal Glioblastoma Multiforme: A Rare Complication in the Management of Head and Neck Cancer
AUTHORS:
Andrew W. Ju, H. Ian Robins, M. Shahriar Salamat, Allison M. Grayev, Steven P. Howard
KEYWORDS:
Central Nervous System, Spinal Cord, Glioblastoma Multiforme, Radiation Induced, Head and Neck Cancer
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.5 No.6,
November
30,
2016
ABSTRACT: Background: Radiation-induced gliomas of the spinal cord are rare late complications
of spinal cord irradiation that typically occur in patients treated at younger
ages. Aim: Raise awareness of radiation induced high grade gliomas with a case
presentation and a review of the literature. Case Presentation: A 50-year-old male
with Stage IVA squamous cell carcinoma of the oropharynx was treated with external
beam radiotherapy with a complete response. Seven years later, he presented with a
cervical spinal cord mass on MRI. An open biopsy was performed. Pathology revealed
an intramedullary WHO grade IV astrocytoma, (i.e., glioblastoma multiforme)
of the cervical spine that fulfilled the criteria for a radiation-induced malignancy. Conclusions : Review of the literature suggests that radiation-induced gliomas
tend to be high grade and may occur at the periphery of an irradiated field. Radiation-induced gliomas of the spinal cord are a serious complication of radiotherapy
that may occur in older patients with head and neck cancers, but are so rare that it
should not affect treatment decisions.