{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:17:00Z","timestamp":1792081020958,"version":"4.4.0"},"reference-count":59,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Brain radiation necrosis is a side effect of radiotherapy that can occur months, or even years, after the end of treatment. From an anatomical\u2013pathological perspective, it is characterized by avascular damage, demyelination, and necrosis. Methods: We present a case of a patient with breast cancer cT2N1M0 and multiple brain metastases occurring at 2 years after diagnosis, who was treated with whole-brain radiotherapy (WBRT) and Stereotactic Radiotherapy (SRT) for tumor progression. Dynamic imaging revealed right parietal post-therapeutic changes in aggravation, requiring differential diagnosis between tumor progression (TP) and brain radionecrosis (BRN). Results: Brain radionecrosis and tumor progression are difficult to differentiate due to their similar radiological and clinical characteristics. MRI perfusion plays an important role in differentiating the two entities. Conclusions: Differentiating radiation necrosis from a recurrent tumor is crucial for appropriate treatment. Medical management includes corticosteroids as first-line treatment, after which bevacizumab is administered as secondary therapy.<\/jats:p>","DOI":"10.3390\/life16040552","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:33:33Z","timestamp":1774622013000},"page":"552","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Challenging Differential Diagnosis Between Brain Radionecrosis and Recurrent Metastatic Disease, with Temporary Clinical\/Radiological Response to Bevacizumab and Later Imaging Suspicious for Oligoprogression"],"prefix":"10.3390","volume":"16","author":[{"given":"Ana Maria","family":"Rata","sequence":"first","affiliation":[{"name":"The Clinical Department, The Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Rahnea-Nita","sequence":"additional","affiliation":[{"name":"Specific Disciplines Department, The Faculty of Nursing and Midwifery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"M Hospital, 010903 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana-Andreea","family":"Rahnea-Nita","sequence":"additional","affiliation":[{"name":"M Hospital, 010903 Bucharest, Romania"},{"name":"The Clinical Department, The Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela Emilia","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, \u201cSfantul Apostol Andrei\u201d Emergency Hospital Galati, 800578 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Nechifor","sequence":"additional","affiliation":[{"name":"The Clinical Department, The Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulia","family":"Chiscop","sequence":"additional","affiliation":[{"name":"The Clinical Department, The Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan-Andrei","family":"Mitrea","sequence":"additional","affiliation":[{"name":"NEUROAXIS, 040215 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorel","family":"Firescu","sequence":"additional","affiliation":[{"name":"The Clinical Department, The Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca","family":"Barzu","sequence":"additional","affiliation":[{"name":"Live Wins Association, 030923 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura-Florentina","family":"Rebegea","sequence":"additional","affiliation":[{"name":"The Clinical Department, The Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University, 800008 Galati, Romania"},{"name":"Radiotherapy Department, \u201cSfantul Apostol Andrei\u201d Emergency Hospital Galati, 800578 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1093\/neuonc\/noac118","article-title":"Brain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions","volume":"24","author":"Aizer","year":"2022","journal-title":"Neuro-Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1093\/neuonc\/noab101","article-title":"Epidemiology of brain metastases and leptomeningeal disease","volume":"23","author":"Lamba","year":"2021","journal-title":"Neuro-Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.nec.2020.06.001","article-title":"Epidemiology of Brain Metastases","volume":"31","author":"Sacks","year":"2020","journal-title":"Neurosurg. 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