Postirradiation Leiomyosarcoma of Rectum Presenting as a Polyp

Abstract

Radiation-induced leiomyosarcomas of the gastrointestinal tract are rare. Very few cases have been documented to date. The histological similarity to gastrointestinal stromal tumor has raised doubts if many of the cases originally reported to be leiomyosarcoma before the widespread use of CD117 were indeed gastrointestinal stromal tumors. We present a case of post-irradiation leiomyosarcoma presenting as a rectal polyp and review the literature.

Leiomyosarcoma of the Rectum as a Radiation-Induced Second Malignancy after Cervical Cancer Treatment: Case Report with Review of the Literature

“…Colorectal sarcomas as a radiation-induced second malignancy after cervical cancer treatment, on contrary to primary ones, are an exceptionally rare entity. Up to date, only five cases had been described in the literature [11–15]. In our current paper, we provide data on the sixth case of similar malignancy.…”

Leiomyosarcoma of the rectum: A systematic review of recent literature

“…Gynecological malignancies are the main cause of irradiationrelated rLMS, followed by prostate cancer and anal cancer. 5,6,8,22,24,25,31,32 In literature, patients are reported to develop radiation-associated soft-tissue sarcomas with a median time interval (Continues) of about 10 years, 35 even though the risk remains significantly high for more than 40 years after radiotherapy. 36 Criteria to consider a malignancy to be radiation-induced are history of radiation, long latent period, histologically proven malignancy within the field of radiation, and different histology of the new tumor if radiation was given for malignancy.…”

“…A wide variety of operations has been reported for rLMS, ranging from endoscopic to pelvic exenteration. 18,25,31 The main issue concerning surgery is whether endoscopic local resection or radical surgery associated with lymphadenectomy should be preferred. Also owing to the fact that diagnosis was rarely achieved preoperatively, histology did not play a major role in surgical management strategy in most cases.…”

Assessment of Secondary Sarcomas Among Patients With Cancer of the Abdomen or Pelvis Who Received Combinations of Surgery, Radiation, and Chemotherapy vs Surgery Alone

“…In contrast, the development of secondary sarcoma after radiation treatment has been well established and there are minimal effects of confounding variables. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 Chemotherapy treatment may also contribute to the development of secondary cancers, particularly hematologic malignant neoplasms, 15 , 16 , 17 , 18 , 19 , 20 , 21 but the relationship between chemotherapy use and sarcoma risk has been poorly studied.…”

“…However, because of the effects of common exposures, including smoking and other confounding factors, the causal relationship remains unclear. In contrast, the development of secondary sarcoma after radiation treatment has been well established and there are minimal effects of confounding variables . Chemotherapy treatment may also contribute to the development of secondary cancers, particularly hematologic malignant neoplasms, but the relationship between chemotherapy use and sarcoma risk has been poorly studied.…”