You Haiping, He Lin, Ouyang Zhibo, Yang Yao, Xie Shu, Zhou Jiwei, Zhang Yun, Shi Jian
Department of Psychosomatic Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Department of Clinical Medicine, Chengdu Medical College, Chengdu, China.
Front Oncol. 2024 Aug 15;14:1422765. doi: 10.3389/fonc.2024.1422765. eCollection 2024.
Radiation encephalopathy (REP) is one of the most common complications of radiotherapy for malignant tumors of the head and neck. Symptoms usually appear months to years following radiotherapy, with headache, insomnia, and memory loss as the main clinical features. We report a patient who was admitted to the hospital with anxiety and depressive disorder and was eventually diagnosed with REP.
A 48-year-old patient who had undergone over 2 years of radiotherapy for nasopharyngeal carcinoma was admitted to the Department of Psychosomatic Medicine of our hospital because of recurrent fear, low mood, and waking up from dreams. Magnetic resonance imaging (MRI) revealed a mass in the left temporal lobe with a large peripheral edema. After multidisciplinary consultation, the possibility of tumor recurrence could not be excluded.
Resection of the lesioned brain tissue to obtain pathological tissue showed glial cell proliferation and small focal areas of degeneration and necrosis, which indicated that the lesions were inflammatory. Postoperative MRI showed no abnormal signal, and the patient's condition improved.
Nasopharyngeal carcinoma patients with a history of radiotherapy and symptoms of increased intracranial pressure and neurological damage should be examined for REP. Furthermore, patients may experience anxiety and depressive disorders as a result of temporal lobe damage caused by REP.
放射性脑病（REP）是头颈部恶性肿瘤放疗最常见的并发症之一。症状通常在放疗后数月至数年出现，主要临床特征为头痛、失眠和记忆力减退。我们报告一例因焦虑和抑郁障碍入院，最终被诊断为REP的患者。
一名48岁鼻咽癌患者，接受了2年多的放疗，因反复恐惧、情绪低落和从梦中惊醒入住我院心身医学科。磁共振成像（MRI）显示左侧颞叶有一肿块，周围有大片水肿。经过多学科会诊，不能排除肿瘤复发的可能性。
切除病变脑组织获取病理组织，显示胶质细胞增生及小灶性变性和坏死，提示病变为炎症性。术后MRI未见异常信号，患者病情好转。
有放疗史且出现颅内压升高和神经损伤症状的鼻咽癌患者应检查是否患有REP。此外，患者可能因REP导致的颞叶损伤而出现焦虑和抑郁障碍。
