Radiation-associated angiosarcoma of the brain with repeated intracerebral hemorrhage: A case report

Delayed side effects of irradiation to the brain are now known to include the induction of new neoplasms. Radiation-induced angiosarcoma of the central nervous system is extremely rare. We report a case of radiation-associated angiosarcoma. A 40-year-old man was taken to our hospital by ambulance with loss of appetite and impaired consciousness. He had undergone radiotherapy for a germinoma of the left basal ganglia 30 years previously. Initial computed tomography of the head showed a large and well-defined mass in the right temporal lobe. This mass showed heterogeneous contrast enhancement at the periphery on gadolinium-enhanced T1-weighted imaging. We performed an initial operation to evacuate the hematoma and the mass. After that, recurrent bleeding occurred, so we performed evacuation of the hematoma and tumor. A final pathological diagnosis of angiosarcoma was made. This is the third case of radiation-associated angiosarcoma in the literature. The authors describe this particular case and review the literature pertaining to angiosarcoma of the brain.