Wang Shaoying, Pan Zilai, Shi Huimin, Wang Pingzhong
Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
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Zhonghua Kou Qiang Yi Xue Za Zhi. 2014 Jan;49(1):5-8.
To evaluate the CT features of radiation-induced jaw osteosarcoma(RIJOS) developed after therapeutic irradiation for a variety of nonosseous lesions.
The demographic and CT findings of thirteen patients with RIJOS were reviewed retrospectively.Observation items included location, bone destruction, mineralized tumor matrix, periosteal reaction, soft tissue extension and calcification.Of the thirteen patients, twelve were male and one was female. The mean age was 48 years (range: 29-68 years).Five patients had tumors in the maxilla and eight in the mandible. All the patients underwent tumor resection.
The latent period before development of RIJOS ranged from 3.5 to 14 years (mean, 11 years).In all thirteen patients, eight tumors were osteoblastic, with one osteolytic and four mixed lesions.Osteoid tumor matrix mineralization was present in twelve patients. Periosteal reaction was identified in 11 cases.Soft-tissue extension was present in all patients beyond the area of bone destruction.
The characteristic CT imaging of RIJOS showed the bone destruction associated with a large number of mineralized tumor matrix and significant soft tissue extension in the original radiation field after radiotherapy. CT findings could play an important role in identifying the tumor and pre-operative assessment.
评估因各种非骨性病变接受治疗性放疗后发生的放射性颌骨骨肉瘤(RIJOS)的CT特征。
回顾性分析13例RIJOS患者的人口统计学资料和CT表现。观察项目包括病变部位、骨质破坏、肿瘤矿化基质、骨膜反应、软组织侵犯及钙化情况。13例患者中,男性12例,女性1例。平均年龄48岁(范围:29 - 68岁)。上颌骨肿瘤5例,下颌骨肿瘤8例。所有患者均接受了肿瘤切除术。
RIJOS发生前的潜伏期为3.5至14年(平均11年)。13例患者中,8例肿瘤为成骨型,1例为溶骨型,4例为混合型。12例患者存在肿瘤骨样基质矿化。11例患者可见骨膜反应。所有患者均存在超出骨质破坏区域的软组织侵犯。
RIJOS的特征性CT表现为放疗后原放射野内骨质破坏伴大量肿瘤矿化基质及明显的软组织侵犯。CT表现对肿瘤的识别及术前评估具有重要作用。