Arteritis and brachial plexus neuropathy as delayed complications of radiation therapy

Radiation-induced arteritis of large vessels and brachial plexus neuropathy are uncommon delayed complications of local radiation therapy. We describe a 66-year-old woman with right arm discomfort, weakness, and acrocyanosis that developed 21 years after local radiation for breast adenocarcinoma. Ar teriography revealed arteritis, with ulcerated plaque formation at the subc lavian-axillary artery junction, consistent with radiation-induced disease, and diffuse irregularity of the axillary artery. Electromyography showed a chronic brachial plexopathy. The patient's acrocyanosis, thought to be due to digital embolization from her vascular disease, improved with antiplate let therapy. The concurrent combination of radiation-induced arteritis and brachial plexopathy is uncommon but should be considered in patients presen ting with upper extremity pain or weakness after radiation therapy.