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Late bilateral temporal lobe necrosis after conventional radiotherapy
Michio Hoshi1, Toshiyuki Hayashi, Hiroshi Kagami
1Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan.
Neurologia Medico-Chirurgica
|May 23, 2003
Summary
Delayed temporal lobe radionecrosis, a rare complication of pituitary adenoma radiotherapy, can manifest as dementia decades later. Surgical intervention improved symptoms in a 63-year-old woman, highlighting delayed radiation effects.
Area of Science:
- Neurology
- Radiation Oncology
- Neurosurgery
Background:
- Pituitary adenomas are commonly treated with radiotherapy.
- Delayed radionecrosis is a known, albeit infrequent, complication of radiation therapy.
- The temporal lobes are particularly vulnerable to radiation-induced injury.
Observation:
- A 63-year-old woman developed dementia 30 years post-radiotherapy for pituitary adenoma.
- Imaging revealed bilateral temporal lobe edema and cystic lesions consistent with radionecrosis.
- Surgical excision of the left temporal lobe lesion led to symptom improvement.
Findings:
- This case illustrates a very late onset of cerebral radionecrosis, occurring 30 years after treatment.
- The findings suggest that radionecrosis can manifest significantly later than typically observed.
- Fractional radiation dose is a critical factor in the development of cerebral radionecrosis.
Implications:
- This case underscores the importance of long-term monitoring for patients treated with cranial radiotherapy.
- Understanding delayed radiation effects is crucial for managing neurological complications.
- Further research into the mechanisms and risk factors for extremely delayed radionecrosis is warranted.