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NEUROLOGY 1998;51:1183-1184
© 1998 American Academy of Neurology

Bilateral temporal lobe necrosis after radiotherapy: Confounding SPECT results

B. de Vries, MD, M.J.B. Taphoorn, MD, J. W. van Isselt, MD, C. H.J. Terhaard, MD, G. H. Jansen, MD and P.H.J.M. Elsenburg, MD

From the Departments of Neurology (Drs. de Vries and Taphoorn), Nuclear Medicine (Dr. van Isselt), Radiotherapy (Dr. Terhaard), Pathology (Dr. Jansen), and Neurosurgery (Dr. Elsenburg), University Hospital Utrecht, The Netherlands.

Address correspondence and reprint requests to DrB. Taphoorn, Department of Neurology, University Hospital Utrecht, P.O. Box 85500, 3584 CX Utrecht, The Netherlands.

A patient with seizures and a contrast-enhancing temporal lesion after radiation therapy for a chondrosarcoma of the nasal septum is described. To differentiate between radiation necrosis and recurrent tumor, thallium-201 (201Tl) SPECT was used. 201Tl SPECT revealed high local accumulation suggesting tumor growth; however, pathologic examination demonstrated focal necrosis with reactive changes but without tumor. The 201Tl SPECT findings in this patient demonstrate a possible diagnostic pitfall in differentiating recurrent tumor from radiation necrosis.

Received February 5, 1998. Accepted in final form May 22, 1998.




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