Cystic radionecrosis

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Distant history of nasopharyngeal carcinoma irradiation.

Patient Data

Age: Adult
ct

Non-contrast CT demonstrates bilateral hypodensity of the temporal poles with cysts and small areas of intracystic hemorrhage. On the left a large cyst exerts significant mass effect. In the setting of prior nasopharyngeal carcinoma treated with radiotherapy, the likely diagnosis is radionecrosis. A radiation-induced tumor could co-exist. 

Case Discussion

Patient underwent a craniotomy and cyst decompression.

Histology confirmed radiation necrosis with no evidence of infection or tumor.

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