Dakin Paul
Woodlands Medical Practice, 54 Leopold Road, London N2 8BG, UK.
Cases J. 2009 Dec 6;2:9150. doi: 10.1186/1757-1626-2-9150.
Therapeutic interventions are made in the best interests of the patient taking into account the risks and benefits believed to be true at the time. However, adverse effects associated with the treatment may only become apparent much later, sometimes long after the anticipated survival of the patient.
A lady in her late sixties presents with multiple pathologies of the head and neck that appear to be a direct consequence of irradiation performed as a young child when she was not expected to live for long. Some deformities resulted early after exposure, but most of the dozen pathologies in the affected area have evolved during the subsequent fifty years.
This case acts as a potent reminder to consider the long term effects of therapeutic ionising radiation, especially if there is a possibility of long term survival post treatment. It also demonstrates the effects of a single physical modality on multiple and wide ranging tissue types, highlighting a continuing need in medical education for the teaching of clinical anatomy and an understanding of histological pathology.
治疗干预措施是在考虑到当时认为真实存在的风险和益处的情况下，为患者的最大利益而做出的。然而，与治疗相关的不良反应可能要很久以后才会显现出来，有时是在预期患者存活时间很久之后。
一位六十多岁的女士出现了头颈部的多种病变，这些病变似乎是她小时候接受放疗的直接后果，当时预计她活不长。一些畸形在照射后早期就出现了，但受影响区域的十几种病变中的大多数是在随后的五十年里逐渐发展的。
这个病例有力地提醒人们要考虑治疗性电离辐射的长期影响，尤其是在治疗后有可能长期存活的情况下。它还展示了单一物理方式对多种广泛组织类型的影响，凸显了医学教育中持续需要教授临床解剖学和理解组织病理学。
