A Case with Cerebral Radiation Necrosis Mimicking Recurrent Brain Tumor

J Korean Neurol Assoc > Volume 17(4); 1999 > Article

Journal of the Korean Neurological Association 1999;17(4): 597-601.

재발성 뇌종양 양상을 보인 방사선 조사에 의한 뇌조직 괴사 1예

이상목, 노학재 ·김주한 ·박운규 ·이영주 ·이규용 ·전하정*

한양대학교 의과대학 신경과학교실,치료방사선과학교실*

A Case with Cerebral Radiation Necrosis Mimicking Recurrent Brain Tumor

Sang Mok Lee, M.D., Hak Jae Noh, M.D., Joo Han Kim, M.D., Woon Gyu Park, M.D., Young Joo Lee, M.D., Gyu yong Lee, M.D., Ha Jung Jun, M.D.*

Department of Neurology and Radiotherapy*, Hanyang University Hospital

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. J Kor Neurol Ass 17(4):596~601, 1999 Key Words : Radiation Necrosis, Brain Tumor, Biopsy