Delayed Radiation Necrosis After Stereotactic Radiosurgery in a Patient Vaccinated for COVID-19: A Case Study and Exploration of Immune-Related Inflammatory Response

By
Tugce Kutuk
Marshall Harrell
Kari Flaute
Christina Flores
Neha Rao
Regan Memmott
James Bradley Elder
Joshua Palmer
July 14, 2026

Frontiers In Oncology

1

Delayed radiation necrosis (RN) can occur several years after stereotactic radiosurgery (SRS), presenting diagnostic challenges.
2

A 66-year-old female with metastatic non-small cell lung cancer developed RN 46 months post-SRS, despite initial treatment success.
3

Imaging showed fluctuating enhancement and edema, complicating the differentiation between RN and recurrent metastases.
4

Histopathology confirmed RN without viable tumor, highlighting the limitations of advanced imaging in diagnosis.
5

Systemic immune activation from COVID-19 vaccinations may theoretically contribute to delayed RN in previously irradiated brain tissue.

Original Source(s)

Frontiers In Oncology

Late radiation necrosis following stereotactic radiosurgery after COVID-19 vaccination: a case report and hypothesis of immune-mediated inflammatory activation

by Tugce Kutuk, Marshall Harrell, Kari Flaute, Christina Flores, Neha Rao, Regan Memmott, James Bradley Elder, Joshua Palmer
July 14, 2026

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