Imaging findings of radiation-induced sarcoma of the head and neck

Abstract

We set out to retrospectively review the clinical and imaging features of patients with post-radiation sarcoma, especially in the head and neck region. We reviewed the records of 4194 patients with carcinoma of the head and neck region who had a history of radiation. They had undergone CT and/or MRI. Medical records were reviewed for the primary diagnosis, radiation history and latency period to the development of sarcoma. The patients included four men and two women with a mean age of 64.5 years. The mean latency period for the development of sarcoma was 11.5 years. Primary diagnoses were maxillary carcinoma, nasopharyngeal carcinoma, adenoid cystic carcinoma of the oral floor, tonsilar carcinoma, soft palate carcinoma and tongue carcinoma. Histopathological examinations revealed osteosarcoma, spindle cell sarcoma, chondrosarcoma, malignant peripheral nerve sheath tumour, spindle cell carcinoma and malignant fibrous histiocytoma, respectively. Common findings were a heterogeneous and well-enhanced soft tissue mass and bone destruction. There is at present little or no prospect for the effective prevention of radiation-induced sarcoma of the head and neck. This emphasizes the importance of the earliest possible diagnosis for such patients. The imaging findings are not diagnosis specific, but strict follow-up within the radiation field by CT and MRI and an appreciation of the expected latency period may help to provide the diagnosis. When radiotherapy is performed for head and neck neoplasms, periodic follow-up observations may be necessary for many years.

Malignant Fibrous Histiocytoma of the Head and Neck: CT and MR Imaging Findings

“…24 MFH has also been reported to occur secondary to irradiation, trauma, Paget disease, osteonecrosis, chronic osteomyelitis, and benign bone tumors such as enchondroma and giant cell tumor. 10,22,23,25 Compared with the tumors that arise de novo, secondary MFHs are reported to be more aggressive with a poorer prognosis. 8,22,24 Head and neck MFH can be confused with a variety of fibrous tumors and inflammatory conditions, including neurilemmoma, fibromatosis, premature sarcoma, hemangiopericytoma, granuloma, nodular fasciitis, malignant mesenchymal tumor, myoblastoma, fat necrosis, Langerhans cell histiocytosis, pleomorphic rhabdomyosarcoma, and fibrosarcoma.…”

A review of adult head and neck soft tissue sarcoma in a tertiary centre: malaysia experience

“…Radiation to the STSHN is also a risk factor. Makimoto et al reported, only six cases (0.14%) of 4184 patients were with a history of radiation, whereas Ko et al, found sarcoma in 0.38% of patients radiated and the most frequent subtype was histiofibrocytoma [15][16] . In our study we did not find any cases of sarcoma associated with radiation.…”

Osteosarcoma of Maxilla with Unusual Image Findings in Child

“…In terms of MR findings, some researchers have reported that osteosarcoma shows low signal intensity on T1W images and heterogeneous high signal intensity on T2W images 6,7) . In this case, the lesion showed low signal intensity on T1W images and a little heterogeneous high signal intensity on T2W images with fat-suppression, which is in agreement with these earlier findings.…”