Previously-treated nasopharyngeal carcinoma with cystic lesions in the temporal lobe

Nasopharyngeal carcinoma is a common malignancy in the Asian Chinese population. First-line treatment consists primarily of radiotherapy and chemotherapy, with salvage surgery if recurrence occurs. Patients with this tumours frequently present years after radiotherapy with symptomatic temporal lobe cystic lesions and a diagnostic problem arises. The possible differential diagnoses include radionecrosis, pyogenic abscesses or tumour recurrence. A series of three cases of cystic temporal lobe lesions, with emphasis on their clinical, radiological and histopathological diagnostic aspects, are presented. The three cases presented consist of radiation necrosis, pyogenic abscess, and a case with both infection with tumour recurrence. The methodology of both clinical and radiological diagnosis are presented.