Radiation induced sarcoma of head and neck: A rare entity
Keywords:
Radiation induced sarcoma (RIS), head and neck tumor, post irradiation.
Abstract
Sarcoma are rare in head and neck region and radiation induced sarcoma (RIS) are even rare and poses challenges for diagnosis and proper management. We report a case of 38 year old male who was treated for carcinoma of right lateral border of tongue with surgery and radiotherapy, and presented with rapidly progressing mass in right floor of mouth after 4 years. Biopsy and imaging confirmed the diagnosis of radiation induced sarcoma and was managed with wide local excision of mass with hemimandibulectomy with reconstruction by pectoralis major mayocutaneous flap. Patient completed the follow up of one and half year and doing well.RIS of head and neck is rare entity and demands multidisciplinary involvement of head and neck, neuro, reconstructive surgeons, radiation oncologists and medical oncologists for optimal management. Though it has poor prognosis but properly managed patients will have the good quality of life.References
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14. Gladdy RA, Qin L-X, Moraco N, Edgar MA, Antonescu CR, Alektiar KM, et al. Do radiation-associated soft tissue sarcomas have the same prognosis as sporadic soft tissue sarcomas? J Clin Oncol Off J Am Soc Clin Oncol. 2010 Apr 20;28(12):2064–9.
15. Thijssens KMJ, van Ginkel RJ, Suurmeijer AJH, Pras E, van der Graaf WTA, Hollander M, et al. Radiation-induced sarcoma: a challenge for the surgeon. Ann Surg Oncol. 2005 Mar;12(3):237–45.
2. Yeang MS, Tay K, Ong WS, Thiagarajan A, Tan DS-W, Ha TC, et al. Outcomes and prognostic factors of post-irradiation and de novo sarcomas of the head and neck: a histologically matched case-control study. Ann Surg Oncol. 2013 Sep;20(9):3066–75.
3. Thiagarajan A, Iyer NG. Radiation-induced sarcomas of the head and neck. World J Clin Oncol. 2014 Dec 10;5(5):973–81.
4. Barcellos-Hoff MH, Nguyen DH. Radiation carcinogenesis in context: how do irradiated tissues become tumors? Health Phys. 2009 Nov;97(5):446–57.
5. Mothersill C, Seymour C. Radiation-induced bystander effects, carcinogenesis and models. Oncogene. 2003 Oct 13;22(45):7028–33.
6. Goldberg Z, Lehnert BE. Radiation-induced effects in unirradiated cells: a review and implications in cancer. Int J Oncol. 2002 Aug;21(2):337–49.
7. Cahan WG, Woodard HQ. Sarcoma arising in irradiated bone; report of 11 cases. Cancer. 1948 May;1(1):3–29.
8. Cha C, Antonescu CR, Quan ML, Maru S, Brennan MF. Long-term results with resection of radiation-induced soft tissue sarcomas. Ann Surg. 2004 Jun;239(6):903-909; discussion 909-910.
9. Huber GF, Matthews TW, Dort JC. Radiation-induced soft tissue sarcomas of the head and neck. J Otolaryngol. 2007 Apr;36(2):93–7.
10. Thariat J, Italiano A, Collin F, Iannessi A, Marcy P-Y, Lacout A, et al. Not all sarcomas developed in irradiated tissue are necessarily radiation-induced--spectrum of disease and treatment characteristics. Crit Rev Oncol Hematol. 2012 Sep;83(3):393–406.
11. Patel SG, See AC, Williamson PA, Archer DJ, Evans PH. Radiation induced sarcoma of the head and neck. Head Neck. 1999 Jul;21(4):346–54.
12. Blay J-Y, Le Cesne A. Adjuvant chemotherapy in localized soft tissue sarcomas: still not proven. The Oncologist. 2009 Oct;14(10):1013–20.
13. 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. 2006 Sep;450:76–81.
14. Gladdy RA, Qin L-X, Moraco N, Edgar MA, Antonescu CR, Alektiar KM, et al. Do radiation-associated soft tissue sarcomas have the same prognosis as sporadic soft tissue sarcomas? J Clin Oncol Off J Am Soc Clin Oncol. 2010 Apr 20;28(12):2064–9.
15. Thijssens KMJ, van Ginkel RJ, Suurmeijer AJH, Pras E, van der Graaf WTA, Hollander M, et al. Radiation-induced sarcoma: a challenge for the surgeon. Ann Surg Oncol. 2005 Mar;12(3):237–45.
Published
2018-03-28
Issue
Section
Case Report
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