Woo E, Lam K, Yu Y L, Ma J, Wang C, Yeung R T
Department of Medicine, University of Hong Kong, Queen Mary Hospital.
J Neurol Neurosurg Psychiatry. 1988 Oct;51(10):1302-7. doi: 10.1136/jnnp.51.10.1302.
Eleven patients with combined neurological and endocrine complications after external radiotherapy for nasopharyngeal carcinoma are described. Neurologically, memory disturbance, complex partial seizures and hypodense areas in one or both temporal lobes on CT were typical features. Endocrinologically, hypopituitarism was the prominent manifestation. This constellation of clinical features in a patient with previous radiotherapy to the nasopharynx characterises radiation injury to the inferomedial aspects of the temporal lobes and the hypothalamic-pituitary axis. While the parenchymal brain lesions may mimic metastases or glioma on CT, the associated endocrine disturbance would betray the correct diagnosis. The importance of recognising the hypopituitarism which may be clinically asymptomatic and which is amenable to therapy is emphasised, as is the need for a proper fractionation of the radiation dose to minimise the incidence of these disabling complications.
本文描述了11例鼻咽癌体外放疗后出现神经和内分泌联合并发症的患者。在神经方面，记忆障碍、复杂部分性发作以及CT显示一侧或双侧颞叶低密度区是典型特征。在内分泌方面，垂体功能减退是主要表现。既往接受过鼻咽放疗的患者出现的这一系列临床特征，是颞叶内下侧及下丘脑 - 垂体轴放射性损伤的特征。虽然脑实质病变在CT上可能类似转移瘤或胶质瘤，但相关的内分泌紊乱有助于做出正确诊断。强调了认识到可能临床无症状但可治疗的垂体功能减退的重要性，以及合理分割放射剂量以尽量减少这些致残性并发症发生率的必要性。
