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Introduction. Angiosarcomas (AS) arising from vascular tissue, accounting for 3.3% of all sarcomas, have a poor prognosis. Radiation-induced AS is a rare late complication of radiotherapy treatment and is characterized by a gene expression profile such as amplification of the MYC oncogene, by which we can distinguish primary from the secondary induced tumor. Case report, At 77-year-old patient, with early-stage endometrial adenocarcinoma, the radical hysterectomy with bilateral salpingo-oophorectomy was initially done. According to pathological risk factors, the postoperative external beam conformal radiotherapy (CRT) of the pelvis was administered with concomitant brachytherapy. Six years after the treatment, on the anterior abdominal wall, in the region of the postoperative irradiation field and surgical scar, an infiltrative angiosarcoma of the skin and subcutaneous adipose tissue, was histologically confirmed. The patient received six cycles of mono-Adriamycin chemotherapy with verified partial regression. Additional immunohistochemical analysis (IHH) of c-MYC, Ki67 and CD34 expression showed a high proliferative index (Ki67 around 60%) and c-MYC positivity indicating the molecular pattern of radiation-induced AS. Furthermore, the high proliferative index could explain a good response to chemotherapy. Conclusion. The novel postoperative radiotherapy techniques provide better survival and local control in risk- endometrial cancer groups with a decrease of irradiation complications. These patients with longer survival, are in a higher risk of developing radiation-induced tumours as late side-effects of radiotherapy. When assessing the probability of radiation-induced AS, IHH analysis of c-MYC expression could distinguish secondary from others AS if Cahan?s criteria are fulfilled.

Ewing sarcoma (ES) is the second most common primary bone malignancy after osteosarcoma. The disease most often occurs in adolescence, with peak incidence around the age of fourteen. The most common primary location of the tumor is the bones of the pelvis, followed by the ribs, spine and long bones of the extremities such as the tibia and the fibula. ES shows a tendency towards hematogenous dissemination, primarily in the lungs and bones, much less often lymphogenously. One third of patients have distant metastases present at initial diagnosis, which is why ES is considered a systemic disease. The treatment of Ewing sarcoma is based on a multimodal approach that includes the use of chemotherapy, surgery and/or radiotherapy. The identification of prognostic parameters enabled the individual treatment of patients based on the assessed risk group. With the application of modern therapeutic protocols, five-year survival for patients with localized disease lies between 60% and 68%, while for patients with metastatic disease, five-year survival is still unsatisfactory and is around 17%. ES belongs to the group of radiosensitive tumors, and radiotherapy plays a very important role in the local control of the disease, in combination with surgical treatment or independently, and can be applied as radical, preoperative or postoperative radiation therapy. Also, radiation therapy has a role in the palliative approach to the treatment of lung metastases and other metastatic sites. Considering that the modern multimodal treatment of Ewing sarcoma leads to long-term survival, it is necessary to take into account the expected side effects of the therapy that can reduce the quality of life of treated patients. Modern radiotherapy techniques such as three-dimensional conformal radiation therapy (3D CRT), intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) enable precise delivery of the prescribed dose of radiation to target volumes with better sparing of surrounding normal tissues and organs, which leads to a lower incidence of late sequelae of radiation therapy and enables the preservation of the quality of life of treated patients.