Presentation
Radionecrosis of the brain presenting as a mass lesion: a case report. J Neurol Neurosurg Psychiatry. 1977 Aug;40(8):827–829. [PMC free article] [PubMed] [Google Scholar] Matsumura H, Ross ER. [ncbi.nlm.nih.gov]
We present a patient who developed cerebral radiation necrosis after protracted fluoroscopy during repeated embolisations of an extracranial arteriovenous malformation. [pn.bmj.com]
Similarly, Wong et al. described the therapeutic effect of bevacizumab in an NPC patient who presented with symptomatic temporal lobe necrosis following definitive radiotherapy (4). [atm.amegroups.com]
Entire Body System
- Asymptomatic
One of the three patients described in detail was asymptomatic; CRN was reduced but then progressed, and a second course of BVZ failed. [benthamscience.com]
Thus, patients may be asymptomatic or may be symptomatic with focal neurological deficits, seizures, features of raised intracranial pressure, or cognitive impairment. [radiopaedia.org]
Treatment
Schmidt4, Lars-Henrik Krarup5 1 Department of Oncology, Rigshospitalet, København, Denmark 2 Department of Pathology, Rigshospitalet, København, Denmark 3 Department of Radiology, Rigshospitalet, København, Denmark 4 Department of Plastic Surgery and Burns Treatment [pn.bmj.com]
Conclusion: Symptoms are an indication of BVZ treatment for primary CRN. Keywords: Bevacizumab, cerebral radiation necrosis, clinical indication, drug usage, signs, symptoms. [benthamscience.com]
Although post-radiation treatment effects include pseudoprogression, which by definition is considered to be radiation treatment-related necrosis, particularly in the setting of concurrent chemotherapy for glioblastoma (Stupp protocol), this article focuses [radiopaedia.org]
Editorial Commentary Radiotherapy is an integral modality in the curative treatment of head and neck and nasopharynx cancers (NPCs) (1). [atm.amegroups.com]
Delayed cerebral radionecrosis following treatment of basal cell carcinoma. Arch Neurol. 1979 Jun;36(6):382–383. [PubMed] [Google Scholar] van Dellen JR, Danziger A. [ncbi.nlm.nih.gov]
Prognosis
[…] usually hypometabolic whereas tumor is hypermetabolic 18F-FET-PET Radiation necrosis has both lower mean and max uptake compared to normal brain parenchyma 7 tumor recurrence has an earlier peak uptake compared to radiation necrosis 7 Treatment and prognosis [radiopaedia.org]