Distant history of nasopharyngeal carcinoma irradiation.
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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.
Patient underwent a craniotomy and cyst decompression.
Histology confirmed radiation necrosis with no evidence of infection or tumor.