1/5. Early radiation-induced malignant fibrous histiocytoma of the oral cavity.With an incidence of less than 0.3 per cent, post-radiation sarcomas are rare malignant neoplasms with a very poor prognosis. On average, they occur after a latency period of at least 15 years following radiation therapy with doses ranging from 24 to 80 Gy. We present the case of a post-irradiation malignant fibrous histiocytoma (MFH) on the floor of the mouth in a 79-year-old male patient arising only five and a half years after radiation therapy. The primary tumour was classified as a well differentiated squamous cell carcinoma of the right rim of the tongue. Primary therapy was surgical resection of the tumour and post-operative radiation with 50 Gy. Five and a half years later, the patient developed a rapidly progressing MFH within the field of radiation.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/5. Immunohistochemical and molecular study of radiation-induced multiple meningiomas with pleural and pulmonary metastasis.In the present study, the telomerase activity and the putative alterations of genes involved in cell-cycle control (p53, Fas and pRb) were investigated in a radiation-induced meningioma with multiple recurrences and pleural-pulmonary metastases (the patient, a 34-year-old male, had a history of carcinoma of the tongue of testicular lymphocytic lymphoma). Expression of VEGF and vasculature pattern were also studied. Expression of VEGF, pRb and p53 were evaluated by immunohistochemistry on formalin-fixed, paraffin-embedded samples of the tumor. VEGFmRNA was determined by competitive PCR. Fas, FasL and hTERT were evaluated by RT-PCR. telomerase activity was examined by the TRAP assay. An intense vascularization was observed, supported by high expression of VEGFmRNA (isoforms 121 and 165). pRb and p53 were overexpressed. Fas was undetectable with PCR, whereas FasL was positive. Furthermore, the lesion showed an elevated telomerase activity (TPG, 22), according to the high expression of hTERT. These findings emphasized that even among generally benign neoplasms, such as meningiomas, some highly malignant tumors may develop, as in our case, in which several mechanisms were activated in the cancer progression to guarantee the immortalization of cellular clones (angiogenic phenomenon, activation of telomerase and of anti-apoptotic mechanisms) and the blood spread. Thus, the data illustrate the importance of searching for genetic aberrations (which are a hallmark of malignancy) in meningiomas, as predictive and reliable factors of the possibility to recur and to metastasize.- - - - - - - - - - ranking = 1.25keywords = radiation-induced (Clic here for more details about this article) |
3/5. fibrosarcoma of the mandible following supravoltage irradiation. Report of a case.Supravoltage irradiation is commonly thought not to be carcinogenic. Several recent studies question this concept, as does our case report. A 50-year-old woman with stage 1 squamous carcinoma of the left side of the tongue was treated in 1973 with 73 Gy of supravoltage irradiation. Twelve years later a painful, ulcerated lesion that eventually was shown to be fibrosarcoma developed in the contralateral mandible. The fibrosarcoma in this case fulfills all criteria for diagnosing radiation-induced neoplasia and demonstrates that supravoltage irradiation, like other forms of irradiation, can cause malignancy. The occasional occurrence of sarcoma should be recalled during follow-up of patients treated with supravoltage radiation. Similarly, the possibility of radiation-induced tumors should be considered in planning treatment for younger patients with tumors that can be treated equally well by surgery or irradiation.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
4/5. Detection of cancer recurrence in irradiated mandible using positron emission tomography.Positron emission tomography (PET) is a promising method for pretherapeutic assessment of spread of squamous cell carcinomas (SCC) in the head and neck. A 41-year-old man with a history of operated and irradiated SCC of the tongue presented 4 years later with symptoms and signs of mandibular osteoradionecrosis. No changes related to malignancy could be seen in panoramic radiographs or computed tomography scanning with contrast enhancement. Since a biopsy of the involved region was positive for SCC, a PET study with [18F]fluorodeoxyglucose (FDG) was performed. In dynamic PET images, intensive uptake of FDG was seen in a small area close to the right mental foramen. A hemimandibulectomy with reconstruction using a free vascularized graft from iliac crest was performed. In the resected specimen, histological examination showed a 1.2-mm focus of SCC in the soft tissue and bone around the mental foramen. These findings indicate that FDG-PET might be useful for presurgical evaluation of cancer recurrence in a previously irradiated mandible, especially if PET can accurately differentiate viable tumor tissue from radiation-induced fibrosis and inflammation.- - - - - - - - - - ranking = 0.25keywords = radiation-induced (Clic here for more details about this article) |
5/5. radiation-induced fibrosarcoma of the tongue.Three patients with a radiation-induced fibrosarcoma of the tongue are presented. All three patients had interstitial radiotherapy and tumour-induction by irradiation seems to be the most likely explanation for the tumour in these patients.- - - - - - - - - - ranking = 0.25keywords = radiation-induced (Clic here for more details about this article) |