Steinke N M, Ostgaard S E, Jensen O M, Nordentoft A M, Sneppen O
Arhus Kommunehospital, sarkomcentret i Arhus, ortopaedkirurgisk afdeling E.
Ugeskr Laeger. 1991 Jun 3;153(23):1655-7.
A well-known complication after irradiation of tissue is development of postradiation sarcomas, and the shoulder girdle is in this connexion a frequent location, because it relatively often is exposured to x-rays. During the period 1956 to 1989 121 patients with sarcomas located to the shoulder girdle were referred to the Sarcoma centre in Arhus. Of these, six were postradiation sarcomas. The indication for the initial irradiation was in two cases cancer of the breast, in one malignant lymfogranulomatosis, in one a metastasis from malignant melanoma and finally two cases of peritendinitis humeroscapularis. In average 15 years (7-26 years) elapsed from irradiation to the diagnosis of the sarcomas. There were four bone sarcomas, two located in the clavicles and 2 in the humeri. Of these, three were osteogenic sarcomas and one a malignant fibrous histiocytoma. There were two soft tissue sarcomas, both located subcutaneously with involvement of deep fascia and muscle. Both tumors were extraskeletal osteogenic sarcomas. Three patients died of tumor on an average after 11 months. Two died without tumor from other causes, and one patient is alive without tumor 11 years after the treatment. If a patients presents with pain at the side of prior radiation, the diagnosis postradiation sarcoma must be considered and the patient referred to the Sarcoma centre. Radiation therapy should not be used in patients with benign lesions.
组织受辐射后一个众所周知的并发症是放射性肉瘤的发生,在这方面,肩胛带是一个常见部位,因为它相对经常受到X射线照射。在1956年至1989年期间,121例肩胛带部位肉瘤患者被转诊至奥胡斯肉瘤中心。其中,6例为放射性肉瘤。初始放疗的指征,2例为乳腺癌,1例为恶性淋巴肉芽肿病,1例为恶性黑色素瘤转移,最后2例为肩胛下肌腱炎。从放疗到肉瘤诊断平均经过15年(7 - 26年)。有4例骨肉瘤,2例位于锁骨,2例位于肱骨。其中,3例为成骨肉瘤,1例为恶性纤维组织细胞瘤。有2例软组织肉瘤,均位于皮下,累及深筋膜和肌肉。这两个肿瘤均为骨外成骨肉瘤。3例患者平均在11个月后死于肿瘤。2例因其他原因无肿瘤死亡,1例患者在治疗后11年无肿瘤存活。如果患者在先前放疗部位出现疼痛,必须考虑放射性肉瘤的诊断,并将患者转诊至肉瘤中心。良性病变患者不应使用放射治疗。