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Permanent iodine-125 beads have been used in the treatment of low- and high-grade gliomas with good results. On computed tomography (CT) and magnetic resonance imaging (MRI), increased enhancement around these beads is common and is usually thought to represent radiation necrosis or disruption of the blood brain barrier. Further investigation of these areas of enhancement is warranted due to the rare possibility of malignant transformation occurring around these beads. Advances in radiological imaging, such as Fludeoxyglucose Positron Emission Tomography (FDG PET), have been useful in differentiating malignant transformation from benign entities. We present the first reported case of a 33-year-old lady with malignant transformation occurring around these beads approximately three years post-resection of a low-grade glioma.

Malignant transformation surrounding iodine-125 beads after treatment of a low grade glioma.