Subcutaneous Calcinosis as Late Sequela of Radiotherapy to the Neck

Abstract

r g The late adverse effects after radiotherapy to the head and neck region include radiation-induced malignancy and changes in the irradiated tissues, leading to chronic xerostomia, radiation caries, osteoradionecrosis, trismus, and dysphagia. Cranial nerve palsy, ocal cord palsy, sensorineural hearing loss, laryngeal steochondronecrosis, extracranial carotid stenosis, adiation myelopathy, and meningioma have also een reported as head and neck postirradiation seuelae. Radiotherapy can also induce dystrophic calcification by causing tumor necrosis and thus providing the milieu necessary for calcification. Although the data are replete with this form of dystrophic calcium deposition that occurs within the tumor after radiotherapy for various malignancies, heterotopic calcification in the subcutaneous tissue, also known as subcutaneous calcinosis, occurs far less frequently as a part of the late effects of radiotherapy. This form of dystrophic calcification develops after a long period of postirradiation latency. It is limited to the subcutaneous tissue and is linked to the late radiation effects of the overlying skin, notably cutaneous atrophy, telangiectasias, depigmentation, fibrosis, and cutaneous fistulas. The development of subcutaneous alcinosis as a late sequel of radiotherapy was first escribed in 1987 by Vainright et al and has since een described predominantly after chest wall irradition for breast cancer. To our knowledge, this is he first report to document the occurrence of this