J Korean Neurol Assoc.  1999 Jul;17(4):597-601.

A Case with Cerebral Radiation Necrosis Mimicking Recurrent Brain Tumor

• Lee SM
• Noh HJ
• Kim JH
• Park WG
• Lee YJ
• Lee KY
• Chun HC

Abstract

Regardless of an appropriate radiation therapy administered to a patient with a brain tumor, clinical and radiological evidence of progression may still develop because of a recurrence of the tumor and/or radiation necrosis, or even rarely, a radiation induced neoplasm. The evaluation of tumor recurrence and radiation-induced necrosis presents a diagnostic challenge. A thirty eight year old woman was treated for a focal motor seizure on the right side of her face.with a fractionated external beam radiotherapy under the impression of cystic astrocytoma in the left frontoparietal region. After 6 months, she developed a headache, nausea and vomiting, dysphagia, and secondary generalized seizure. A follow-up brain MRI showed a high signal mass lesion in a T2 weighted image and a fluorodeoxyglucose PET revealed hypometabolism in the left frontoparietal lobe, suggesting radionecrosis. It was confirmed as radionecrosis with an expanding edema by open biopsy. We report a cerebral radiation necrosis mimicking recurrent brain tumor.

Keyword

Radiation Necrosis; Brain Tumor; Biopsy

MeSH Terms

Astrocytoma
Biopsy
Brain
Brain Neoplasms*
Deglutition Disorders
Edema
Female
Follow-Up Studies
Headache
Humans
Magnetic Resonance Imaging
Nausea
Necrosis*
Radiotherapy
Recurrence
Seizures
Vomiting