How would you approach a symptomatic patient with with a history of whole brain RT with new bilateral MRI enhancing lesions within the optic nerves?

Topics: Radiation Oncology • Palliation • Neuro-Oncology • Thoracic Malignancies • Medical Oncology

Would you suspect progressive disease v. radiation necrosis vs optic neuritis due to immunotherapy. Eyes were within radiation field 8 months ago.

Answer from: Radiation Oncologist at Community Practice

The differential would be optic neuritis from immunotherapy or leptomeningeal disease. Is there any visual deficit? It appears there is a lesion as described above rather than enhancement which would favor disease. One would need to know the disease status outside brain and if there is any ot...

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Medical Oncologist at Kaiser Permanente
Lesions appear as discrete and mass like and are w...

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