Figure 2: Representative gadolinium-enhanced T1-weighted magnetic resonance images from the first patient described in Figure 1. Two-year postpresentation, the patient developed a left medial temporal lobe metastasis (a, arrow) treated with stereotactic radiosurgery. Seven months after stereotactic radiosurgery, the patient developed a headache and a mixed aphasia. Magnetic resonance imaging showed a heterogeneously enhancing mass with significant surrounding edema (b). The patient underwent surgical resection, and the pathologic diagnosis was adverse radiation effect [Figure 1, Panel A]. The patient's symptoms resolved after surgical resection. There is no evidence of recurrent disease at 2 years after surgery (c)