Melanocytic Hyperpigmentation of the Tongue from Low-dose Radiotherapy

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RJ Amdur, PR Sandow, A Yeung, WM Mendenhall

Hong Kong J Radiol 2010;13:32-5

Several of our patients developed patches of melanotic hyperpigmentation (black spots) in the mucosa of the tongue during radiotherapy for brain tumours. The purpose of this report was to describe a representative case with a literature review. A 39-year-old African American female received 6 weeks of radiotherapy for an optic nerve meningioma. During the last week of radiotherapy, she developed patches of melanotic hyperpigmentation in the mucosa of the oral tongue that were psychologically disturbing to her. There was no associated tongue discomfort, oral inflammation, infection, or pigmentation change elsewhere. Her medical history and list of medications did not yield any potential contributing factors. The radiation dose to the oral cavity was very low (10 Gy over 6 weeks); the oral cavity received only the exit dose from a single beam angle. We elected to observe her without biopsy or treatment. After 3 months, the patches started to fade and had completely resolved 12 months following radiotherapy. We have seen several additional patients with this same feature. This is the first publication to describe patches of melanotic hyperpigmentation in the tongue from lowdose radiotherapy. Health care providers who see patients receiving radiotherapy for brain or head-and-neck tumours will benefit from our analysis of this phenomenon.




RJ Amdur, PR Sandow, A Yeung, WM Mendenhall

我們曾接觸數名因腦腫瘤接受放射治療而出現舌頭黏膜黑色素沉著(黑點)的病例。本文討論其中 一個具代表性的例子並回顧有關文獻。一名39歲美國黑人女性,因患上視神經鞘腦膜瘤而接受六個 星期的放射治療。在放射治療的最後一個星期,病人因在舌頭黏膜上有黑色素沉著而造成心理困 擾。除此以外,病人並沒有舌頭不適、口腔發炎、感染或其餘部位的色素轉變。了解病歷及病人曾 服食的藥物都未能找出原因。病人口腔接受的放射劑量相當低(六個星期共10 Gy),而且口腔部分 只接受單束角的出射劑量。我們決定繼續觀察,並未為病人做切片或施以其他治療。三個月後黑點 開始減褪;放射治療十二個月後,黑點完全消失。我們曾接觸幾位病人有類似的情況。本文是首例 有關低劑量放射治療引致舌頭黑色素沉著的病例報導,這分析報告可讓醫護人員對因腦或頭頸部腫 瘤而接受放射治療的病人有更多了解。