Should we irradiate a brain tumor in a patient with parkinsonism? A case report and literature review

Patients with PD do not harbor an increased risk for the development of cancer in general and have similar incidence of brain tumors as the general population. Tumor-induced parkinsonism is a rare entity. Parkinsonism as a side effect of brain radiation is an uncommon phenomenon, even after high doses, but is associated with limited response to medical management. Rare cases in children, typically associated with bilateral imaging changes, have been described, which suggests possible uncommon genetic predisposition. There are no convincing reports that suggest that pre-existing parkinsonism is worsened by radiation therapy, although a mechanistic possibility for this exists. Functional radiosurgery for management of refractory tremor in PD patients is safe and effective. Radiation therapy, either fractionated or stereotactic radiosurgery, appears to be safe when used judiciously for patients with PD, for the treatment of either tumors or PD itself.