Section 3 - Disease related to treatment

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Diffuse necrotizing leukoencephalopathy

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Case 25  

A 25 year old man with ALL
This patient had undergone CNS prophylaxis with IT-MTX and RT. He then received IT-MTX and ARA-C for CNS relapse. He experienced a seizure and sudden left-sided hemiparesis shortly after an intrathecal treatment. MRI (postcontrast T1) demonstrated an ugly, enhancing mass in the right hemisphere. There was extensive T2 signal hyperintensity. Biopsy revealed only necrosis.

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