Objective: Radiotherapy is often employed in the treatment of recalcitrant acromegaly. Osteoradionecrosis is among the most serious complications of radiotherapy. Proper diagnosis of ORN is important for early initiation of treatment in the form of surgical debridement and sequestrectomy, and/or hyperbaric oxygen (HBO) therapy. Study Design: Case report Methods: A 49 year-old male with a history of acromegaly secondary to a pituitary adenoma, who completed surgical debulking and external beam radiotherapy (5400 cGy) 4 years prior, presented for concern of tumor recurrence. Transphenoidal clival biopsy showed no evidence of tumor recurrence or osteomyelitis; the absence of these findings and presence of fibrosis and chronic inflammation was consistent with osteoradionecrosis of the clivus. Conclusion: Osteoradionecrosis is a rare, but serious complication of radiotherapy, which may present several years following completion of treatment. It should be included in the differential diagnosis of an expansive lesion in the context of post-radiation therapy. To our knowledge, this is the first report of osteoradionecrosis following radiotherapy for acromegaly.
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