Sarcoma arising in irradiated bone

Cahan, William G.; Woodard, Helen Q.; Higinbotham, Norman L.; Stewart, Fred W.; Coley, Bradley L.

doi:10.1002/(sici)1097-0142(19980101)82:1<8::aid-cncr3>3.0.co;2-w

Cited by 562 publications

(262 citation statements)

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“…The diagnostic criteria, as originally reported by Cahan et al, 7 specified a latency period of at least 5 years. Since then, there have been several reports of patients developing radiation-induced sarcomas with shorter latency periods (as short as 2 years).…”

Section: Discussionmentioning

confidence: 99%

“…22 It is thought that delivery of a minimum radiation dose of 30 Gy to a field is required for the development of radiation-induced sarcomas. 7,14 Most postradiation sarcomas have been reported to develop after doses of 55 to 60 Gy; however, there have also been reports of sarcomas after doses as low as 16 Gy. 5,23 This is consistent with our series, in which the mean radiation dose was 53.4 Gy.…”

Section: Discussionmentioning

confidence: 99%

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Radiation‐induced osteosarcomas of the calvarium and skull base

Patel

Rao

Fox

et al. 2010

Cancer

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BACKGROUND: Although a rare complication of ionizing radiation, radiation-induced osteosarcoma is now more frequently recognized as radiation therapy has become common and cancer survival has increased. To date, publications on radiation-induced osteosarcoma of the cranium are limited to a few small series and case reports. METHODS: Data from 175 patients with a history of sarcoma of the head at The University of Texas M. D. Anderson Cancer Center from 1975 to 2007 were reviewed to identify patients with radiation-induced osteosarcoma. The diagnostic criteria were: 1) osteosarcoma arose within the previously irradiated field; 2) new sarcoma was histologically distinct from the original neoplasm; 3) no evidence of new sarcoma at the time of radiation; and 4) distinct latency period could be recognized. Frequencies and descriptive statistics were obtained for the various characteristics under study. RESULTS: The authors identified 16 patients with radiation-induced osteosarcoma of the cranium at their institution. The average age at diagnosis was 35 years. The median latency period was 12.5 years. Nine patients had skull base tumors, and 7 had calvarial tumors. Of the 14 patients treated surgically, 86% developed local recurrence. The median survival time was 29 months, and the 5-year survival rate was 29.6%. CONCLUSIONS: The authors report the largest series of cranial radiation-induced osteosarcoma. Although radiation-induced osteosarcoma is an uncommon but dire complication of radiotherapy, its incidence will probably increase in the future as the frequency of radiation treatment and cancer survival increase. These tumors are locally aggressive, and despite aggressive surgical and medical management, they have a high rate of local recurrence and mortality. Cancer 2011;117:2120-6.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Radiation‐induced osteosarcomas of the calvarium and skull base

Patel

Rao

Fox

et al. 2010

Cancer

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“…This suggests a possible multifactorial etiology that should be investigated [14]. The criteria established by Cahan et al [15] are widely used for the diagnosis of radiotherapy-induced sarcoma: a history of radiotherapy, an asymptomatic latency period of several years (5 or more), an occurrence of sarcoma within a previously irradiated field, and a histological confirmation of the sarcomatous nature of the post-irradiation lesion. The case described here doesn't fulfill these criteria.…”

Section: Discussionmentioning

confidence: 99%

Breast angiosarcoma one year after adenosquamous endometrial cancer — diagnostic pitfalls

et al. 2012

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AbstractAngiosarcoma of the breast is a rare and very aggressive tumors originated from endothelial cells lining blood vessels. We report a case of a 55-year-old postmenopausal female with a primary breast angiosarcoma diagnosed just a one year after radical hysterectomy and radiation therapy due to endometrial cancer. The patient initially presented with postmenopausal bleeding. Cytology and biopsy of the endometrium were performed and endometrial adenosquamous carcinoma was diagnosed followed by radical hysterectomy and postoperative local radiatiotherapy (50 Gy). One year later patient presented with a great painful tumorous mass in the right breast. Physical examination revealed an oval tumor, located in upper and outer quadrant of the right breast, around 15 cm in diameter. Mammography and ultrasonography were performed. The angiosarcoma of the breast was confirmed by biopsy. The patient underwent radical mastectomy. Histopathology proved the diagnosis of angiosarcoma (high-grade, numerous mitoses over 10/10 HPF, necrosis, “blood lakes”, infiltrative borders). Differential diagnosis of a breast angiosarcoma should be considered in all painful breast tumours no mather the time and the location of the previous radiation treatment even if benign characteristics of these masses have been detected by mammography and breast ultrasound.

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“…6) The first description of the basic conditions establishing the cause and effect of radiation-induced sarcoma was reported in 1948. 1) The criteria for radiation-induced tumor were further clarified, as follows: the tumor occurs in the radiation field; a latent period, usually years, occurs between the irradiation and the development of the secondary tumor; the two tumors have distinctly different histology; and predisposing factors such as neurofibromatosis for the development of multiple tumors are absent. 5) The present case fulfills these criteria.…”

Section: Discussionmentioning

confidence: 99%