Article Text

Download PDFPDF
CASE REPORT
Severe vincristine-induced polyneuropathy in a teenager with anaplastic medulloblastoma and undiagnosed Charcot-Marie-Tooth disease
  1. Yasmin Aghajan1,
  2. Janet M Yoon2,
  3. John Ross Crawford3
  1. 1 School of Medicine, University of California San Diego, San Diego, California, USA
  2. 2 Division of Hematology-Oncology, Department of Pediatrics, Rady Children’s Hospital-San Diego, San Diego, California, USA
  3. 3 Neurosciences and Pediatrics, University of California San Diego, San Diego, California, USA
  1. Correspondence to Dr John Ross Crawford, jrcrawford{at}ucsd.edu

Summary

Severe neuropathy is a known adverse effect of vincristine in patients with Charcot-Marie-Tooth disease (CMT). We present the case of a 16-year-old girl with anaplastic medulloblastoma treated with gross total resection and high-dose craniospinal radiation with adjuvant vincristine chemotherapy who developed acute-onset severe quadriplegia and vocal cord paralysis. Vincristine and radiation therapy were discontinued. Although her neuropathy slowly improved over several weeks, she developed metastatic extraneural medulloblastoma and died 5 months after diagnosis. Subsequent genetic testing revealed previously asymptomatic and undiagnosed CMT1A. Our case highlights the importance of early recognition of acute vincristine neurotoxicity that should raise suspicion of an underlying hereditary neuropathy.

  • Neurology
  • Neuromuscular disease
  • Neurooncology
  • CNS cancer
  • Chemotherapy
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors JRC and JMY were involved in the diagnosis and treatment of the patient. YA and JRC did the literature search and wrote the manuscript. All authors have reviewed the case report and agree to its content prior to submission.

  • Competing interests None declared.

  • Patient consent Obtained from guardian.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.