Antineoplastics
1
Reactions 1498, p8 - 26 Apr 2014 S Antineoplastics Cavernous malformations of the brain in children: 2 case reports Two children with acute lymphocytic leukaemia (ALL) developed cavernous malformations of the brain following cranial irradiation and chemotherapy [dosages not stated]. A girl diagnosed with ALL at 5 years of age received chemotherapy with IV vincristine, doxorubicin [adriamycin], prednisone, asparaginase, methotrexate, mercaptopurine and intrathecal cytarabine and methotrexate. She also received cranial irradiation of 2400 cGy. Six years later, she developed seizures. Radiology showed a cavernous malformation in the left temporal lobe. She underwent stereotactic radiosurgery, but the malformation continued to grow. She developed right hemiparesis, headache and speech disturbances. An MRI showed an enlarged left temporal lobe cavernous malformation with associated haemorrhage and oedema. Six years after stereotactic radiosurgery, she underwent left temporal craniotomy for resection of the lesion. Her condition improved after surgery, and she became seizure-free. A boy diagnosed with ALL at 4 years of age received 2 years of chemotherapy with IV vincristine, prednisone, doxorubicin, methotrexate, asparaginase and mercaptopurine and intrathecal cytarabine and methotrexate. He also received cranial irradition of 1800 cGy. At 8 years of age, he presented with numbness on the left side of his body. An MRI showed haemorrhage from a right posterior frontal cavernous malformation. Additional small cavernous malformations or areas of old haemorrhage were seen throughout both hemispheres. He underwent right frontotemporal craniotomy for resection of the lesion. Four years later, a repeat MRI demonstrated no residual lesion or recurrence. Six years after the first haemorrhage, he developed blurry vision and headache. An MRI revealed haemorrhage from a newly detected right occipital cavernous malformation. He underwent right occipital craniotomy for resection of the lesion, and his symptoms resolved. Author comment: "Children treated for ALL with cranial irradiation and chemotherapy may develop cavernous malformations of the brain." Singla A, et al. Cavernous malformations of the brain after treatment for acute lymphocytic leukemia: presentation and long-term follow-up. Journal of Neurosurgery: Pediatrics 11: 127-32, No. 2, Feb 2013 - USA 803102291 1 Reactions 26 Apr 2014 No. 1498 0114-9954/14/1498-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1498, p8 - 26 Apr 2014
SAntineoplastics
Cavernous malformations of the brain in children:2 case reports
Two children with acute lymphocytic leukaemia (ALL)developed cavernous malformations of the brain followingcranial irradiation and chemotherapy [dosages not stated].
A girl diagnosed with ALL at 5 years of age receivedchemotherapy with IV vincristine, doxorubicin [adriamycin],prednisone, asparaginase, methotrexate, mercaptopurine andintrathecal cytarabine and methotrexate. She also receivedcranial irradiation of 2400 cGy. Six years later, she developedseizures. Radiology showed a cavernous malformation in theleft temporal lobe. She underwent stereotactic radiosurgery,but the malformation continued to grow. She developed righthemiparesis, headache and speech disturbances. An MRIshowed an enlarged left temporal lobe cavernousmalformation with associated haemorrhage and oedema. Sixyears after stereotactic radiosurgery, she underwent lefttemporal craniotomy for resection of the lesion. Her conditionimproved after surgery, and she became seizure-free.
A boy diagnosed with ALL at 4 years of age received 2 yearsof chemotherapy with IV vincristine, prednisone, doxorubicin,methotrexate, asparaginase and mercaptopurine andintrathecal cytarabine and methotrexate. He also receivedcranial irradition of 1800 cGy. At 8 years of age, he presentedwith numbness on the left side of his body. An MRI showedhaemorrhage from a right posterior frontal cavernousmalformation. Additional small cavernous malformations orareas of old haemorrhage were seen throughout bothhemispheres. He underwent right frontotemporal craniotomyfor resection of the lesion. Four years later, a repeat MRIdemonstrated no residual lesion or recurrence. Six years afterthe first haemorrhage, he developed blurry vision andheadache. An MRI revealed haemorrhage from a newlydetected right occipital cavernous malformation. Heunderwent right occipital craniotomy for resection of thelesion, and his symptoms resolved.
Author comment: "Children treated for ALL with cranialirradiation and chemotherapy may develop cavernousmalformations of the brain."Singla A, et al. Cavernous malformations of the brain after treatment for acutelymphocytic leukemia: presentation and long-term follow-up. Journal ofNeurosurgery: Pediatrics 11: 127-32, No. 2, Feb 2013 - USA 803102291
1
Reactions 26 Apr 2014 No. 14980114-9954/14/1498-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
