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Radiation-induced sarcoma masquerading as osteoradionecrosis: case report and literature review

Published online by Cambridge University Press:  04 February 2015

J Wood ,
J Ver Halen ,
S Samant  and
N Florendo
J Wood
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
J Ver Halen*
Affiliation:
Department of Plastic and Reconstructive Surgery, Baptist Cancer Center, Memphis, Tennessee, USA Department of Surgery, Vanderbilt Ingram Cancer Center, Nashville, Tennessee, USA Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee, USA
S Samant
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
N Florendo
Affiliation:
Department of Pathology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
*
Address for correspondence: Dr Jon Ver Halen, 3268 Duke Circle, Germantown, Tennessee 38139, USA E-mail: jpverhalen@gmail.com
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Abstract

Background:

Radiation therapy is a commonly used treatment in head and neck oncology, whether used alone or as an adjunct to other treatments. Osteoradionecrosis and radiation-induced malignancy are both rare, late complications of radiation therapy.

Methods:

This paper describes a case of radiation-induced sarcoma of the mandible initially presenting as osteoradionecrosis. In addition, the literature on the identification and treatment of these entities is reviewed.

Results:

The patient underwent excision and reconstruction of the presumed osteoradionecrosis. Final pathology demonstrated radiation-induced sarcoma. The patient suffered tumour recurrence at seven months post-operatively.

Conclusion:

When evaluating a patient with osteoradionecrosis, clinicians should be cognisant of the risk of malignancy. This paper describes the first case of radiation-induced sarcoma presenting as osteoradionecrosis. Primary treatment of radiation-induced sarcoma is wide surgical extirpation, with a very limited role for chemotherapy. Overall survival for this entity is poor.

Keywords

Neoplasms, Radiation-InducedSarcomaOsteoradionecrosisMandibleFree Tissue FlapsReview
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 3 , March 2015 , pp. 279 - 282
Copyright
Copyright © JLO (1984) Limited 2015 

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