NIMG-67. DISAPPEARING DOTS – TRANSIENT LATE ENHANCING LESIONS YEARS AFTER BRAIN RADIOTHERAPY
| Autor: | Teri Kreisl, Fabio M. Iwamoto, Elizabeth J. Buss, Oscar Padilla, Aya Haggiagi, Angela Lignelli-Dipple, Marissa Barbaro, Laura Donovan, Carl D. Elliston, Tony J. C. Wang, Jeffrey N. Bruce, Adela Joanta-Gomez, Mary Welch, Peter Canoll, Peter Pan, Andrew B. Lassman |
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| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Anaplastic oligodendroglioma Brain radiotherapy Astrocytoma Neuroimaging Magnetic resonance imaging medicine.disease Radiation therapy Radiation necrosis Oncology Medicine Neurology (clinical) Radiology business Glioblastoma |
| Zdroj: | Neuro Oncol |
| ISSN: | 1523-5866 1522-8517 |
| Popis: | BACKGROUND Late-delayed radiation effects appear 6 months to years following radiotherapy. We characterize a species of small enhancing lesions in the late-delayed phase of post-radiotherapy that are distinct from the classic descriptions of radiation necrosis or pseudoprogression associated with mass effect and edema. These “disappearing dots” are small, do not exert mass effect nor edema, and spontaneously resolve. METHOD We retrospectively describe a series of cases with “disappearing dots” following brain radiotherapy. RESULTS There were 10 cases (4 men), median age 42 years (range 29-63). Diagnoses were glioblastoma (3); low grade astrocytoma, anaplastic astrocytoma, and anaplastic oligodendroglioma (2 each); and solitary fibrous tumor (1). All patients received 54-60 Gy (Gray) of external beam radiotherapy, except one (proton beam therapy to 60 cobalt Gray equivalent). Disappearing dots appeared at a median of 27 months (range 5-197) post-radiotherapy. Lesions were relatively small (~< 1 cm3), peri-ventricular, and within the radiotherapy field. Most enlarged before resolving. Advanced MR imaging and fluorodeoxyglucose (FGD)-PET results were inconsistent. Lesions persisted a median of 8.5 months (range 1-49) before spontaneous resolution. All were asymptomatic. Biopsy in one case revealed treatment effects rather than recurrent tumor. CONCLUSIONS Asymptomatic small periventricular enhancing lesions can develop and remit spontaneously, years following brain radiotherapy. Such disappearing dots should be part of the differential diagnosis along with tumor recurrence. of new enhancing lesions in the late-delayed phase post-radiotherapy. |
| Databáze: | OpenAIRE |
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