Cystic Radionecrosis: A Case Report and Literature Review

Introduction: Cerebral radionecrosis is a rare but serious iatrogenic complication that occurs in patients who have undergone radiation therapy for various types of cancer, such as brain metastases or nasopharyngeal carcinoma. It can have significant consequences on the health and quality of life of affected individuals. Case Report: We report the case of a 65-year-old man, previously treated and declared cured of nasopharyngeal cancer, who was admitted to the intensive care unit for the management of a super-refractory status epilepticus secondary to cerebral radionecrosis. Discussion: Cerebral radionecrosis, most commonly localized in the temporal region, is becoming increasingly frequent among patients who have received radiotherapy for nasopharyngeal cancer. One of the main strategies to prevent this complication is to limit the radiation dose. The clinical symptoms of cerebral radionecrosis vary, ranging from mild to severe. It may be discovered incidentally during imaging in an asymptomatic patient or present with neurological symptoms on clinical examination. MRI is the preferred modality for diagnosing and monitoring this condition. However, distinguishing radionecrosis from a recurrence in the form of brain metastasis is often challenging. Conclusion: Cerebral radionecrosis is a rare and serious complication. Brain imaging plays a major role in its diagnosis. In the absence of an effective treatment, prevention through improved dosimetric planning is essential.