Figure 3: Case information for a 69-year-old with lung adenocarcinoma. A right parietal brain metastasis was treated with stereotactic radiosurgery (a). Two months after stereotactic radiosurgery, the tumor had significantly decreased in size (b). Fifteen months after stereotactic radiosurgery, the patient developed seizures and was found to have a recurrent gadolinium-enhancing mass (c) with significant surrounding edema (d). The seizures were refractory to medical management, and the patient underwent complete resection of the mass (e). Pathology slides (f and g), (H and E, ×200) show a background of fibrinoid necrosis with hyalinization of blood vessels (arrows) and residual metastatic carcinoma (stars). There is no test to determine the activity level of the residual metastatic disease. At 6 months postoperatively, the patient had no further seizures, and there was no evidence of recurrent gadolinium-enhancement on magnetic resonance imaging of the brain (not shown)