Radiation-induced brain necrosis during pregnancy: a delayed complication of gestational trophoblastic neoplasia

Harsha Shah; Jessica Phillips; Mandish K Dhanjal; Pooja Dassan; Michael Seckl; Charlotte Frise

doi:10.1177/1753495X251354997

Radiation-induced brain necrosis during pregnancy: a delayed complication of gestational trophoblastic neoplasia

Obstet Med. 2025 Jul 4:1753495X251354997. doi: 10.1177/1753495X251354997. Online ahead of print.

Authors

Harsha Shah¹, Jessica Phillips¹, Mandish K Dhanjal¹, Pooja Dassan¹, Michael Seckl², Charlotte Frise¹

Affiliations

¹ Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.
² Imperial College London, London, UK.

Abstract

Radiation-induced brain necrosis (RIBN) is a rare but serious delayed complication of intracerebral radiotherapy. We present the case of a 34-year-old woman with a history of gestational trophoblastic neoplasia (GTN) with brain metastases, who presented with symptoms related to RIBN at 20 weeks' gestation in a subsequent pregnancy. These included right homonymous inferior quadrantanopia and headaches. We describe the imaging and diagnostic tests used to assess for GTN recurrence and the specific management of RIBN in pregnancy within a multidisciplinary care setting.

Keywords: Trophoblastic neoplasms; brain metastases; neoplastic; neurology; pregnancy complications.