Radiation-Induced Cavernoma Progression: Case Report and Literature Review

Abstract

This article reports a rare case of radiation-induced cavernoma progression in an adult patient following treatment for a brainstem cavernoma. Cavernomas are benign vascular malformations that may occur sporadically or be associated with ionizing radiation. While radiotherapy is effective in treating central nervous system (CNS) tumors and symptomatic cavernomas, it can also induce late adverse effects, such as the formation of new cavernomas. The patient, a 47-year-old man, underwent radiotherapy after experiencing refractory seizures due to a brainstem cavernoma. Initially, clinical improvement was observed, but eight months after treatment, new cavernoma lesions appeared, worsening the clinical picture. Radiotherapy can stabilize existing cavernomas but is also associated with the formation of new ones due to vascular endothelial damage. These effects may manifest years after radiation exposure, with a latency period ranging from 1 to 26 years. Magnetic resonance imaging (MRI) plays a key role in diagnosis and monitoring. Although radiotherapy is a valid option when surgery is contraindicated, long-term follow-up is essential to detect complications and adjust therapeutic strategies.