1/15. Postirradiation aortic sarcoma demonstrated by magnetic resonance angiography.This is the first ever reported case of a radiation-induced aortic sarcoma. This patient had symptoms and signs initially interpreted as a pulmonary embolus. The extent of the disease was demonstrated with magnetic resonance imaging and magnetic resonance angiography, in particular, allowing rapid surgical intervention.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/15. radiation-induced bone sarcoma following total body irradiation: role of additional radiation on localized areas.A 44-year-old patient who had had acute monoblastic leukemia developed an osteosarcoma of the pelvic bones 5 years after an allogeneic bone marrow transplant from his HLA-identical sister. He had additionally received superficial cutaneous radiation of the legs and pelvis, over the 3 weeks prior to total body irradiation (TBI), because of cutaneous leukemic lesions. The tumor was a fibrohistiocytomatous osteogenic sarcoma. The first lesion was in the right ilium, and a second lesion appeared 18 months later, symmetrically on the left ilium. Despite treatment, the patient died from metastases. At the time of diagnosis of radiation-induced sarcoma, the patient was free of leukemia and had several risk factors already reported to favor the development of solid tumors in stem cell recipients. These include acute leukemia, TBI and graft-versus-host disease. As he developed symmetrical lesions of the pelvic bone, and because of the histology of the radiation-induced tumor, we assumed that the additional radiation of the skin prior to TBI may have contributed to the pathogenesis of this malignant fibrous histiocytoma. Therefore, the risk/benefit ratio should be carefully considered in unusual indications. These patients should benefit from a close follow-up of the superimposed areas.- - - - - - - - - - ranking = 2keywords = radiation-induced (Clic here for more details about this article) |
3/15. interferon-gamma in 5 patients with cutaneous radiation syndrome after radiation therapy.BACKGROUND: Irradiation can cause acute inflammatory responses as well as chronic fibrotic alterations of the skin. Cutaneous radiation fibrosis evokes a complex of therapeutic problems. However, therapeutic options, apart from surgical approaches, are limited. patients AND methods: Five female patients suffering from severe cutaneous fibrosis were treated with interferon-gamma on a low-dose regimen, 3 x 100 microg/week subcutaneously for 6 months, then once per week for another 6 months. In 4 patients, skin thickness was measured with high-frequency (20 MHz) ultrasound in a clinically well-defined target skin lesion. In 1 patient, nuclear magnetic resonance imaging was performed to quantify the extent of cutaneous radiation fibrosis and to monitor the therapeutic outcome. RESULTS: All patients suffered from radiation-induced cutaneous fibrosis. Additionally, in 1 patient, a fistula, as assessed by lymph vessel scintigraphy, and in another patient a radiation ulcer was diagnosed. In all patients, reduction of radiation-induced fibrosis could be documented. Both fistula and radiation ulcer regressed completely under interferon-gamma therapy. CONCLUSION: Low-dose interferon-gamma therapy is a new and effective treatment modality for cutaneous radiation fibrosis caused by radiation therapy. The positive impact of interferon-gamma on our patients warrants randomized double-blind trials on therapy of radiation fibrosis.- - - - - - - - - - ranking = 2keywords = radiation-induced (Clic here for more details about this article) |
4/15. radiation-induced cancers of the pharynx and larynx: a study of five clinical cases.radiation-induced cancer, a rare clinical entity, is often difficult to diagnose and manage. This study reports a series of five cases of radiocarcinogenesis of the pharynx and/or larynx that developed after external radiotherapy. The primary lesion was diagnosed at a mean age of 50 years ( /-12.9) and the radiation-induced cancer at a mean age of 59 years ( /-13.1), giving a latent period of 9 years ( /-3.7). Analysis of gammagraphic records indicated that four of the patients had developed a secondary tumour in the penumbra of irradiation fields. In these zones, the delivered dose was between 20 and 80% of the prescribed dose, corresponding to an estimated cumulative mean dose of 14.1-56.3 Gy. These results are compared with data in the literature to determine the diagnostic criteria for radiation-induced cancer, possible predisposition (genetic or acquired) and the dose effect.- - - - - - - - - - ranking = 2keywords = radiation-induced (Clic here for more details about this article) |
5/15. Jejunal free-flap reconstruction complicated by development of post-irradiation sarcoma: what information should patients receive about the long-term effects of radiotherapy for head and neck tumours?Jejunal free-flap reconstruction is a well recognized, reliable technique commonly used for reconstruction of the upper aero-digestive tract following surgery for malignancy, and radiotherapy is commonly used as an adjuvant treatment in such cases. Unfortunately, post-irradiation sarcomas are a well recognized complication of radiotherapy and generally have a poor prognosis. We report what we believe to be the first case of radiation-induced sarcoma in a free-flap jejunal graft and discuss the information that should be given to patients undergoing radiotherapy to head and neck tumours.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
6/15. Composite tissue transfer in limb-salvage surgery.After extensive resection due to extremity sarcoma, the inability to cover the defect for satisfactory healing and limb function has been an indication for amputation rather than limb salvage. We report herein our experience with seven limb-salvage cases in which we closed difficult and complex defects with composite tissue transfers utilizing microvascular techniques. Free-flap transfers were used to cover soft-tissue defects after extensive resection of primary and locally recurrent tumor and to manage radiation-induced complications. The grafts healed well when infected irradiated tissue was covered, and the grafts tolerated postoperative irradiation. Composite tissue transfer also provided soft-tissue coverage around distal joints that would not have been adequately protected with a skin graft. Complications were minimal, and all patients maintained good extremity function. No patient who underwent composite tissue transfer has had a local recurrence. A free-flap composite tissue transfer can extend the indications for limb-salvage surgery and offers an alternative to amputation in selected patients.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
7/15. radiation-induced sarcoma of the breast in a female adolescent. Case report with histologic and therapeutic considerations.A 14-year-old girl developed a radiation-induced sarcoma of the left breast after successful combined surgical and radiation therapy of a left adrenal carcinoma when she was 9 months old. The breast lesion was histologically described as a stromal sarcoma with fibrosarcomatous and myxosarcomatous areas. The second primary lesion and local recurrence of this was treated with surgery. At each recurrence the tumor became more aggressive both clinically and histologically, and eventually proved fatal.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
8/15. Alveolar soft part sarcoma following radiotherapy for a spinal hemangioma. A case report.A case of alveolar soft part sarcoma arising some 20 years later in a site previously irradiated as a treatment for a spinal cord hemangioma is described. This is the first known case of radiation-associated alveolar soft part sarcoma, and it fulfills the criteria for a tumor to be radiation-induced. The coincidental finding of "viral-like" particles within some of the tumor cells was noted.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
9/15. Uterine sarcoma following adjuvant radiotherapy for rectal carcinoma.Since adjuvant radiotherapy for rectosigmoid carcinoma appears to improve prognosis, the importance of delayed side effects such as radiation-induced malignant disease must be considered. The present report describes the first reported case of the development of a uterine carcinosarcoma more than 9 years after preoperative radiotherapy to the midpelvis for rectal carcinoma.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
10/15. Hodgkin's disease complicated by radiation sarcoma in bone.Seven patients after treatment of Hodgkin's disease who developed bone sarcomas in the radiation field were seen at this centre over the past eight years. radiation-induced sarcoma in bone in patients with Hodgkin's disease is poorly documented. The large number of cases appeared to be an important new development and led to our review of all the patients with radiation-induced sarcomas (RIS) seen at this centre over the past 40 years. Thirty-seven patients with RIS in previously normal bone were found, and of these, only one patient with underlying Hodgkin's disease, who was seen here 27 years earlier. Hodgkin's disease and breast cancer were the most common primary underlying conditions and, as a result, the bones of the shoulder girdle were the commonest site of radiation-induced sarcoma. The clinical histories and radiographic findings of the eight patients with underlying Hodgkin's disease are discussed in detail.- - - - - - - - - - ranking = 2keywords = radiation-induced (Clic here for more details about this article) |
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