A case of delayed radiation-induced lumbosacral radiculoplexopathy after 30 years

Lumbosacral radiculoplexopathy in colon cancer treatment is a very rare but serious complication after radiation. We report here a 66-year-old man with slowly progressive lower limb weakness which arose 30 years after local radiation treatment for colon cancer. Electrophysiological studies revealed signs of denervation confined to the lower limbs. Other causes were excluded by clinical presentation, serological, cerebrospinal fluid and imaging studies. This case shows that delayed radiation-induced lumbosacral radiculoplexopathy can occur 30 years after the initial treatment. Neurology Asia 2015; 20(3) : 297 – 299 Address for correspondence: Sang-Soo Lee, MD, Department of Neurology, Chungbuk National University College of Medicine, 1 Chungdae-ro SeowonGu, Cheongju, Chungbuk 362-763, Korea. Tel: +82-43-269-6336, Fax: +82-43-275-7591, E-mail: [email protected] INTRODUCTION With improved long-term cancer survival, chronic or delayed complications of treatments become a medical and public health concern. Radiation therapy is a common adjunctive modality used in the treatment of colorectal cancer after surgical ablation. Radiation-induced peripheral neuropathy is one of the most serious complications as the resultant disability may have considerable impact on quality of life of cancer survivors. However, till to-date, radiation-induced neuropathies have not received much attention among the health care professionals. Its occurrence is thought to be rare, but the incidence is increasing due to growing number of long-term cancer survivors. We present here a patient in whom lumbosacral radiculoplexopathy developed 30 years after irradiation for descending colon cancer.