Abstract
Introduction. Tension pneumocephalus (TP) is a very rare complication related to radiotherapy for nasopharyngeal carcinoma (NPC). Case Presentation. A 46-year-old man was admitted to the hospital with an altered mental status and aqueous rhinorrhea for several hours of evolution. The computed tomography (CT) scan showed TP, a defect in the skull base and nasocranial fistula. The patient was receiving a second course of radiotherapy for local relapse. With medical treatment the patient recovered neurological status but died two days later. Discussion. In our knowledge, only 4 cases with similar characteristics have been reported in the literature. This is the first case report of TP during radiotherapy. TP was an abrupt and rapid process with neurological impairment for hours of evolution without suspicious osteoradionecrosis (OR) in previous scan images. The defect in the skull base could be due to a rapid disappearance of the tumor. The appearance of aqueous rhinorrhea and neurological symptoms must be viewed as signs of alarm.
Highlights
Tension pneumocephalus (TP) is a very rare complication related to radiotherapy for nasopharyngeal carcinoma (NPC)
We report a case of a patient diagnosed with NPC who developed TP during reirradiation for tumor relapse
A 46-year-old man was admitted to the hospital with an altered mental status and aqueous rhinorrhea
Summary
Nasopharyngeal carcinoma (NPC) is an uncommon malignant tumor. In these cases, the standard treatment is high doses of conformal radiotherapy with chemotherapy [1]. TP is very uncommon pathology and most cases occur during the postoperative posterior fossa surgery [2]. TP related to radiotherapy is a very rare complication. We report a case of a patient diagnosed with NPC who developed TP during reirradiation for tumor relapse. Only 4 cases with similar characteristics have been reported in the literature. This is the first case report of TP during radiotherapy
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