Delayed cerebral radiation necrosis occurring twice at different regions and times in a patient with a metastatic brain tumour.

No case of histopathologically confirmed delayed cerebral radiation necrosis (DCRN) that occurred twice at different regions and times in the same patient has been previously reported. We present a patient with such a rare clinical course and who is surviving long-term (over 13 years) with a history of a distant metastasis of a malignant tumour. To diagnose DCRN preoperatively was very difficult. However, surgical extirpation seemed to be effective for DCRN. The patient is still in a good performance status after surgery.