Posterior Reversible Encephalopathy Syndrome During Combined Modality Therapy for Head and Neck Squamous Cell Carcinoma

Objectives: Posterior reversible encephalopathy syndrome (PRES) is a rare and acute disease with central nervous system symptoms. Without appropriate therapy, patients may exhibit a poor prognosis. PRES should be recognized as a possible problem during therapy for head and neck squamous cell carcino...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2016-10, Vol.125 (10), p.844-849
Main Authors: Wakasaki, Takahiro, Gotoh, Seiji, Tomonobe, Eri, Mihara, Takenao, Fukushima, Junichi
Format: Article
Language:English
Subjects:
Brain - diagnostic imaging
Carcinoma, Squamous Cell - diagnostic imaging
Carcinoma, Squamous Cell - therapy
Chemoradiotherapy - adverse effects
Diffusion Magnetic Resonance Imaging
Esophagus - surgery
Female
Head and Neck Neoplasms - diagnostic imaging
Head and Neck Neoplasms - therapy
Humans
Hypopharyngeal Neoplasms - diagnostic imaging
Hypopharyngeal Neoplasms - therapy
Laryngectomy
Magnetic Resonance Imaging
Middle Aged
Neck Dissection
Pharyngectomy
Posterior Leukoencephalopathy Syndrome - diagnostic imaging
Posterior Leukoencephalopathy Syndrome - etiology
Postoperative Complications - diagnostic imaging
Postoperative Complications - etiology
Reconstructive Surgical Procedures
Squamous Cell Carcinoma of Head and Neck
Tomography, X-Ray Computed
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Summary:Objectives: Posterior reversible encephalopathy syndrome (PRES) is a rare and acute disease with central nervous system symptoms. Without appropriate therapy, patients may exhibit a poor prognosis. PRES should be recognized as a possible problem during therapy for head and neck squamous cell carcinoma (HNSCC). Methods: A 56-year-old female developed PRES during combined modality therapy for HNSCC. On the fourth day after surgery and following chemoradiotherapy, PRES developed with a sudden visual disorder, followed by headache located at the back of the head and convulsions accompanied by impaired consciousness. We diagnosed PRES based on the clinical manifestations and magnetic resonance imaging data. Results: The patient recovered from PRES by appropriate treatment. Conclusion: This is the first case report of PRES developed during treatment for HNSCC. Masked by other cerebrovascular disorders, more cases of PRES could exist than usually expected; therefore, we should consider PRES as a differential diagnosis for central nervous system disorders developing during high-intensity therapy.
ISSN:0003-4894
1943-572X
DOI:10.1177/0003489416654710