Abstract
Radiation-induced osteosarcoma is a rare complication after irradiation of primary malignancies. In the chest wall, it is usually secondary to radiotherapy for breast cancer or lymphoma. We report a rare case of radiation-induced osteosarcoma of the sternum after mediastinal irradiation of a thymoma. A 49-year-old woman presented with a sternal tumor 17 years after surgery plus mediastinal irradiation (50 Gy) for a stage III thymoma. On biopsy, this second tumor was diagnosed as a radiation-induced osteosarcoma. Systemic survey revealed additional metastatic spread to vertebrae and pelvis. Despite intensive combination chemotherapy that initially stabilized her disease, the patient died 2 years after the diagnosis was made. Because thymoma patients receiving mediastinal irradiation are thus at additional risk of radiation-induced secondary malignancy, long-term follow-up is advisable.
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References
Mayer R, Aigner C, Stranzl H, Preidler KW, Guss H, Hackl A. Radiation-induced osteosarcoma of the chest wall. Breast J 2002;8(5):320–322.
Schwarz RE, Burt M. Radiation-associated malignant tumors of the chest wall. Ann Surg Oncol 1996;3(4):387–92.
Cahan WG, Woodard HQ, Higinbotham NL, Stewart FW, Coley BL. Sarcoma arising in irradiated bone: report of eleven cases (1948). Cancer (Phila) 1998;82:8–34.
Shaheen M, Deheshi BM, Riad S, Werier J, Holt GE, Ferguson PC, et al. Prognosis of radiation-induced bone sarcoma is similar to primary osteosarcoma. Clin Orthop Relat Res 2006; 450:76–81.
Bielack SS, Kempf-Bielack B, Heise U, Schwenzer D, Winkler K. Combined modality treatment for osteosarcoma occurring as a second malignant disease: cooperative German-Austrian-Swiss Osteosarcoma Study Group. J Clin Oncol 1999;17: 1164–1174.
Longhi A, Fabbri N, Donati D, Capanna R, Briccoli A, Biagini R, et al. Neoadjuvant chemotherapy for patients with synchronous multifocal osteosarcoma: results in eleven cases. J Chemother 2001;13(3):324–330.
Kager L, Zoubek A, Pötschger U, Kastner U, Flege S, Kempf-Bielack B, et al. Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols. J Clin Oncol 2003; 21(10):2011–2018.
Utsumi T, Shiono H, Matsumura A, Maeda H, Ohta M, Tada H, et al. Stage III thymoma: relationship of local invasion to recurrence. J Thorac Cardiovasc Surg 2008;136(6):1481–1485.
Okumura M, Ohta M, Tateyama H, Nakagawa K, Matsumura A, Maeda H, et al. The World Health Organization histologic classification system reflects the oncologic behaviour of thymoma: a clinical study of 273 patients. Cancer (Phila) 2002;94(3):624–632.
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Kadota, Y., Utsumi, T., Inoue, M. et al. Radiation-induced osteosarcoma 17 years after mediastinal irradiation following surgical removal of thymoma. Gen Thorac Cardiovasc Surg 58, 651–653 (2010). https://doi.org/10.1007/s11748-010-0587-x
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DOI: https://doi.org/10.1007/s11748-010-0587-x