Post-radiotherapy Pelvic Sarcoma Following Carcinoma Endometrium Treatment

Abstract

Background Post-radiation sarcoma accounts for 0.5-5.5 % of all sarcomas. We present a rare case of postradiation malignant peripheral nerve sheath tumor (MPNST) of pelvic following radiotherapy for endometrium carcinoma. Case report A 48-year-old woman with diagnosis of endometrioid carcinoma of uterus underwent surgical staging in March 2009. Histopathological report shows endometrioid adenocarcinoma grade II, infiltrating more than half thickness of myometrium (FIGO stage IB GrII). The patient received adjuvant pelvic radiotherapy administered by external beam followed by vaginal brachytherapy till July 2009. The patient was followed regularly without any signs of recurrence till April 2015, and then on PET-CT scan single active lesion near anterosuperior to urinary bladder was found. Wide local excision of tumor was done. Histopathological and immunohistochemistry findings were consistent with malignant peripheral nerve sheath tumor.Conclusion Post-irradiation MPNST should be considered in the differential diagnosis of an enlarging mass in a previously irradiated area. Therefore, careful follow-up after effective radiotherapy should be continued for lifelong for these patients as early diagnosis of second cancer may help in more effective treatment of these tumors.