Radiation therapy for a head and neck cancer can rarely result in ischemic necrosis of the tongue.
Patient selection: head and neck cancer treated with radiation
Clinical features:
(1) The patient is usually a smoker.
(2) The patient has atherosclerosis of arteries in the head and neck.
(3) Following radiation therapy the patient develops ischemic necrosis of the tongue.
(4) No other explanation can explain the findings better.
The radiation induces an obliterative endarteritis. When superimposed on atherosclerosis this may be sufficient to cause ischemia.
Smoking cessation and therapy with drugs that interfere with platelet function may restore perfusion.
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Specialty: Hematology Oncology, Otolaryngology
