Severe vincristine-induced polyneuropathy in a teenager with anaplastic medulloblastoma and undiagnosed Charcot-Marie-Tooth disease.

Abstract

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.

• Authors: Yasmin Aghajan, Janet M Yoon, John Ross Crawford
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2017 (Apr 24 2017) ISSN: 1757-790X [Electronic] England
• PMID: 28438772 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Chemical References

• Antineoplastic Agents, Phytogenic
• Vincristine

Topics

• Adolescent
• Antineoplastic Agents, Phytogenic (adverse effects)
• Brain Neoplasms (drug therapy, radiotherapy)
• Charcot-Marie-Tooth Disease (genetics)
• Chemotherapy, Adjuvant
• Combined Modality Therapy
• Fatal Outcome
• Female
• Humans
• Medulloblastoma (drug therapy, radiotherapy)
• Polyneuropathies (chemically induced, genetics)
• Vincristine (adverse effects)