Transtentorial herniation caused by an intracranial mass lesion following high-dose methotrexate.

Abstract

A patient with intracranial osteosarcoma that arose 16 years after radiation therapy for hereditary retinoblastoma developed fatal cerebral edema and brainstem herniation after she received a single dose of intravenous methotrexate. Autopsy demonstrated extensive necrosis of the tumor mass, as well as necrotizing vascular damage within the neoplasm. Although high-dose methotrexate has been shown to be useful in the treatment of primary osteogenic sarcoma, the tumoricidal effects of therapy appear to have caused a fatal rise in intracranial pressure.

• Authors: B Villareal, L G Baum, H V Vinters, S A Feig
• Journal: The American journal of pediatric hematology/oncology (Am J Pediatr Hematol Oncol) Vol. 12 Issue 2 Pg. 215-9 ( 1990) ISSN: 0192-8562 [Print] United States
• PMID: 2378415 (Publication Type: Case Reports, Journal Article)

Chemical References

• Methotrexate

Topics

• Adolescent
• Combined Modality Therapy
• Encephalocele (etiology)
• Eye Neoplasms (drug therapy, radiotherapy, surgery)
• Female
• Humans
• Infusions, Intravenous (adverse effects)
• Intracranial Pressure
• Methotrexate (adverse effects)
• Necrosis
• Neoplasms, Multiple Primary
• Neoplasms, Radiation-Induced (complications, drug therapy)
• Orbital Neoplasms (complications, drug therapy)
• Osteosarcoma (complications, drug therapy)
• Retinoblastoma (drug therapy, radiotherapy, surgery)