Rashidghamat Elham, Calonje Jaime Eduardo
St. John's Institute of Dermatology, Guy's and St Thomas' NHS Trust, London, UK.
J Cutan Pathol. 2018 May;45(5):352-354. doi: 10.1111/cup.13103. Epub 2018 Mar 12.
Radiation-induced sarcoma (RIS) is an unusual but well documented tumor. The frequency of RIS of the head and neck region has been reported as 0.143%. In the literature the median interval between irradiation and development of sarcoma is 11 years. Cases of RIS with a short latent period, that is, less than 4 years are rare. We report a case of a 34-year-old female who developed an osteosarcoma of the scalp, over a previous craniotomy scar, 3 years after excision of a frontal anaplastic oligodendroglioma which had been followed by a course of 6 weeks radiotherapy (58 Gy) and 6 cycles of temozolomide. The histological features were those of a high-grade osteosarcoma with epidermotropism of tumor cells. Lymph nodes were partially replaced by high-grade metastatic osteosarcoma, with extra-nodal lymphatic tumor thrombi. To our knowledge the only other case report of post-radiation osteosarcoma with a short latency period was a case of osteosarcoma in the craniofacial bone 3 years after radiotherapy for maxillary squamous cell carcinoma. The histological finding of prominent replacement of the epidermis by osteosarcoma has not been reported before.
放射性肉瘤（RIS）是一种罕见但有充分文献记载的肿瘤。头颈部RIS的发生率据报道为0.143%。文献中肉瘤发生与放疗之间的中位间隔时间为11年。潜伏期短（即少于4年）的RIS病例罕见。我们报告一例34岁女性，在切除额叶间变性少突胶质细胞瘤并接受6周放疗（58 Gy）及6个周期替莫唑胺治疗3年后，在既往开颅手术瘢痕处发生头皮骨肉瘤。组织学特征为高级别骨肉瘤伴肿瘤细胞亲表皮性。淋巴结部分被高级别转移性骨肉瘤取代，伴有结外淋巴管肿瘤血栓形成。据我们所知，另一例放疗后潜伏期短的骨肉瘤病例报告是上颌鳞状细胞癌放疗3年后发生在颅面骨的骨肉瘤。骨肉瘤显著取代表皮的组织学表现此前未见报道。
