Raheem Omer A, Hickey David P
Department of Urology and Transplantation, Beaumont Hospital, Dublin, Ireland.
J Med Case Rep. 2011 Apr 14;5:148. doi: 10.1186/1752-1947-5-148.
Postirradiation lumbosacral syndrome is a radiculopathy induced by radiation injury to the spinal cord. Its usual presentation is motor deficit and or sensory loss involving the lower limbs. Visceral involvement has not been reported previously.
We describe a case of severe hypotonic bladder caused by radiation-induced spinal cord injury following treatment of stage Ι testicular seminoma in a 38-year-old Caucasian man who had undergone radical orchidectomy and prophylactic paraaortic lymph node irradiation for stage Ι seminoma. Three years later he had clinical and urodynamic findings of hypotonic bladder. The magnetic resonance imaging results suggested a radiation-induced injury.
Such an unusual presentation of the syndrome of postirradiation lumbosacral radiculopathy can impose a clinical challenge to practicing clinicians. Future studies are required to further delineate the mechanism of injury and further management plans.
放射后腰骶综合征是一种因脊髓辐射损伤所致的神经根病。其常见表现为下肢运动功能障碍和/或感觉丧失。此前尚未有内脏受累的报道。
我们描述了一例38岁白人男性，在接受根治性睾丸切除及针对Ⅰ期精原细胞瘤的预防性腹主动脉旁淋巴结照射后，因放射性脊髓损伤导致严重张力性膀胱的病例。三年后，他出现了张力性膀胱的临床及尿动力学表现。磁共振成像结果提示为放射性损伤。
放射后腰骶神经根病综合征的这种不寻常表现会给临床医生带来临床挑战。需要进一步研究以明确损伤机制及进一步的治疗方案。
