Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T11:25:52.180Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Fangman, W, Cook, J. Postradiation sarcoma: case report and review of the potential complications of therapeutic ionizing radiation. Dermatol Surg 2005;31:966–72Google Scholar
2Sale, K, Wallace, DI, Girod, DA, Tsue, TT. Radiation-induced malignancy of the head and neck. Otolaryngol Head Neck Surg 2004;131:643–5Google Scholar
3Gutierrez, V, Llorente Pendas, JL, Coca Pelaz, A, Cabanillas Farpon, R, Suzarez Nieto, C. Radiation-induced sarcomas of the head and neck. J Craniofac Surg 2008;19:1287–91CrossRefGoogle Scholar
4Marx, RE. A new concept in the treatment of osteoradionecrosis. J Oral Maxillofac Surg 1983;41:351–7CrossRefGoogle ScholarPubMed
5Maghami, EG, St-John, M, Bhuta, S, Abemayor, E. Postirradiation sarcoma: a case report and current review. Am J Otolaryngol 2005;26:71–4CrossRefGoogle ScholarPubMed
6Cai, PQ, Wu, YP, Li, L, Zhang, R, Xie, CM, Wu, PH et al. CT and MRI of radiation-induced sarcomas of the head and neck following radiotherapy for nasopharyngeal carcinoma. Clin Radiol 2013;68:683–9Google Scholar
7Thariat, J, Italiano, A, Collin, F, Iannessi, A, Marcy, PY, Lacout, A et al. Not all sarcomas developed in irradiated tissue are necessarily radiation induced—spectrum of disease and treatment characteristics. Crit Rev Oncol Hematol 2012;83:393–406Google Scholar
8Wei-wei, L, Qiu-liang, W, Guo-hao, W, Zhi-hua, C, Zong-yuan, Z. Clinicopathologic features, treatment, and prognosis of postirradiation osteosarcoma in patients with nasopharyngeal cancer. Laryngoscope 2005;115:1574–9Google Scholar
9Chabchoub, I, Gharbi, O, Remadi, S, Limem, S, Trabelsi, A, Hochlef, M et al. Postirradiation osteosarcoma of the maxilla: a case report and current review of literature. J Oncol 2009;2009:876138CrossRefGoogle ScholarPubMed
10Debnam, J, Guha-Thakurta, N, Mahfouz, YM, Garden, AS, Benjamin, RS, Sturgis, EM et al. Radiation-associated head and neck sarcomas: spectrum of imaging findings. Oral Oncol 2012;48:155–61Google Scholar
11Seethala, RR, Sturgis, EM, Raymond, AK, Deavers, MT. Postirradiation osteosarcoma of the mandible with heterologous differentiation. Arch Pathol Lab Med 2006;130:385–8Google Scholar
12Mertens, F, Larramendy, M, Gustavsson, A, Gisselsson, D, Rydholm, A, Brosjo, O et al. Radiation-associated sarcomas are characterized by complex karyotypes with frequent rearrangement of chromosome arm 3p. Cancer Genet Cytogenet 2000;116:89–96Google Scholar
13Menu-Branthomme, A, Rubino, C, Shamsaldin, A, Hawkins, MM, Grumaud, E, Dondon, MG et al. Radiation dose, chemotherapy and risk of soft tissue sarcoma after solid tumors during childhood. Int J Cancer 2004;110:87–93Google Scholar
14Lagrange, JL, Ramaioli, A, Chateau, MC, Marchal, C, Resbeut, M, Richaud, P et al. Sarcoma after radiation therapy: retrospective multiinstitutional study of 80 histologically confirmed cases. Radiation Therapist and Pathologist Groups of the Federation Nationale des Centres de Lutte Contre le Cancer. Radiology 2000;216:197–205Google Scholar
15Bjerkehagen, B, Smeland, S, Walberg, L, Skeldal, S, Hall, KS, Nesland, JM et al. Radiation-induced sarcoma: 25-year experience from the Norwegian Radium Hospital. Acta Oncol 2008;47:1475–82CrossRefGoogle ScholarPubMed