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

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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  • 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)

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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