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Malignant peripheral nerve sheath tumor of the spine after radiation therapy for Hodgkin's lymphoma.

Publication ,  Journal Article
Adamson, DC; Cummings, TJ; Friedman, AH
Published in: Clin Neuropathol
2004

We report the development of a malignant peripheral nerve sheath tumor (MPNST) in 2 patients after irradiation for Hodgkin's lymphoma. Clinicians should be aware of this uncommon, but important fatal complication of radiation therapy. The first case is a 37-year-old man who was diagnosed with nodular sclerosing (NS) Hodgkin's lymphoma and underwent successful mantle radiation. He presented to our neurosurgery service with a left C6 radiculopathy 6 years later. The second case is a 30-year-old female diagnosed with NS Hodgkin's lymphoma. She did well with extensive radiotherapy until 5 years later when she developed severe right arm and chest pain secondary to recurrent lymphoma. After aggressive radio- and chemotherapy, she presented to the neurosurgery service with a right Horner's syndrome, right C6 radiculopathy, and weakness of her right triceps and wrist extensors. Both patients obtained magnetic resonance imaging revealing intradural extramedullary cervical nerve root associated mass lesions. Two years after radiation therapy for his Hodgkin's lymphoma, the first patient underwent a C6 laminectomy at an outside institution for resection of a benign neurofibroma. Four years later, he underwent a posterior C5-7 laminectomy with lateral mass plate fusion and partial excision of a recurrent mass diagnosed as a MPNST. The second patient underwent a C5-6 hemilaminectomy and partial resection of a tumor also pathologically consistent with MPNST. We present 2 case reports of patients who developed neurofibrosarcomatous tumors with malignant transformation after undergoing radiation therapy for Hodgkin's lymphoma. Despite prompt surgical resection, these tumors exhibited aggressive behavior. Numerous cases of soft tissue tumors have been described to arise in areas of prior radiation therapy; however, there have been rare reports of de novo MPNST after radiation therapy, especially in the setting of Hodgkin's lymphoma. Postirradiation MPNST should be considered in the differential diagnosis of a painful, enlarging mass in a previously irradiated area.

Duke Scholars

Published In

Clin Neuropathol

ISSN

0722-5091

Publication Date

2004

Volume

23

Issue

5

Start / End Page

245 / 255

Location

Germany

Related Subject Headings

  • Spinal Neoplasms
  • Neurology & Neurosurgery
  • Nerve Sheath Neoplasms
  • Neoplasms, Radiation-Induced
  • Male
  • Magnetic Resonance Imaging
  • Lymphatic Irradiation
  • Humans
  • Hodgkin Disease
  • Fatal Outcome
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Adamson, D. C., Cummings, T. J., & Friedman, A. H. (2004). Malignant peripheral nerve sheath tumor of the spine after radiation therapy for Hodgkin's lymphoma. Clin Neuropathol, 23(5), 245–255.
Adamson, D. C., T. J. Cummings, and A. H. Friedman. “Malignant peripheral nerve sheath tumor of the spine after radiation therapy for Hodgkin's lymphoma.Clin Neuropathol 23, no. 5 (2004): 245–55.
Adamson DC, Cummings TJ, Friedman AH. Malignant peripheral nerve sheath tumor of the spine after radiation therapy for Hodgkin's lymphoma. Clin Neuropathol. 2004;23(5):245–55.
Adamson, D. C., et al. “Malignant peripheral nerve sheath tumor of the spine after radiation therapy for Hodgkin's lymphoma.Clin Neuropathol, vol. 23, no. 5, 2004, pp. 245–55.
Adamson DC, Cummings TJ, Friedman AH. Malignant peripheral nerve sheath tumor of the spine after radiation therapy for Hodgkin's lymphoma. Clin Neuropathol. 2004;23(5):245–255.

Published In

Clin Neuropathol

ISSN

0722-5091

Publication Date

2004

Volume

23

Issue

5

Start / End Page

245 / 255

Location

Germany

Related Subject Headings

  • Spinal Neoplasms
  • Neurology & Neurosurgery
  • Nerve Sheath Neoplasms
  • Neoplasms, Radiation-Induced
  • Male
  • Magnetic Resonance Imaging
  • Lymphatic Irradiation
  • Humans
  • Hodgkin Disease
  • Fatal Outcome