Diffusion restriction in a non-enhancing metastatic brain tumor treated with bevacizumab - recurrent tumor or atypical necrosis?

Abstract

A 38-year-old female with metastatic brain cancer developed non-enhancing, diffusion restricted lesions following bevacizumab treatment. From our review of the literature, this is the first reported case of this type of lesion. Clinicians should be wary of these lesions, as they can represent either tumor progression or necrosis/effects of chronic hypoxia from anti-angiogenic therapy. Further investigation is necessary to determine the biological mechanism and clinical significance of this type of imaging appearance.

• Authors: Lakshmanan Sivasundaram, Saman Hazany, Naveed Wagle, Gabriel Zada, Thomas C Chen, Alexander Lerner, John L Go, Francesco D'Amore, Meng Law, Mark S Shiroishi
• Journal: Clinical imaging (Clin Imaging) 2014 Sep-Oct Vol. 38 Issue 5 Pg. 724-6 ISSN: 1873-4499 [Electronic] United States
• PMID: 24910165 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• Bevacizumab

Topics

• Adult
• Angiogenesis Inhibitors (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Bevacizumab
• Brain Neoplasms (diagnosis, secondary)
• Breast Neoplasms (diagnosis, secondary)
• Diagnosis, Differential
• Female
• Humans
• Necrosis (diagnosis)
• Neoplasm Metastasis
• Neoplasm Recurrence, Local (diagnosis)
• Occipital Lobe (pathology)
• Parietal Lobe (pathology)