Kristenson Scott, Mann Ryan, Leafblad Korey, Cook Benjamin, Chang James
Madigan Army Medical Center, 9040A Jackson Ave, Tacoma, WA 98431, USA.
Radiol Case Rep. 2019 Nov 11;15(1):89-94. doi: 10.1016/j.radcr.2019.10.021. eCollection 2020 Jan.
Radiation-induced sarcomas are a known, rare, complication from prior therapeutic radiation therapy. Radiation-induced sarcomas have been reported to have poor associated prognoses with increased morbidity and mortality when compared to primary sarcomas. In this case report, we discuss a 27-year-old female who presented at the age of 17 during pregnancy with an inability to bear weight and was subsequently diagnosed with Ewing's sarcoma of her femur. Adequate response to treatment was obtained with the initial treatment and the patient represented with acute, severe pain of her femur at the site of prior Ewing's. Extensive workup demonstrated radiation-induced osteosarcoma at the site of her prior Ewing's sarcoma in the radiation field. Multidisciplinary teams including orthopedics, pathology, medical oncology, and radiology are vital for appropriate and efficacious diagnosis of radiation-induced sarcomas. Despite the rarity of radiation-induced sarcoma, the ability to recognize and diagnose recurrent sarcoma is important for radiologists, particularly considering the associated poor prognosis. Early diagnosis and aggressive multidisciplinary treatment is crucial to improving patient morbidity and mortality. In this case, the diagnosis of radiation-induced osteosarcoma allowed expedited workup and initial aggressive, lifesaving treatment for our patient.
放射性肉瘤是已知的一种因先前接受放射治疗而引发的罕见并发症。据报道，与原发性肉瘤相比，放射性肉瘤的相关预后较差，发病率和死亡率更高。在本病例报告中，我们讨论了一名27岁女性，她在17岁孕期时出现无法负重的症状，随后被诊断为股骨尤因肉瘤。初始治疗取得了充分的治疗反应，但患者后来在先前尤因肉瘤部位出现了股骨急性剧痛。全面检查显示，在放疗区域内先前尤因肉瘤部位发生了放射性骨肉瘤。包括骨科、病理学、医学肿瘤学和放射学在内的多学科团队对于准确有效地诊断放射性肉瘤至关重要。尽管放射性肉瘤罕见，但放射科医生识别和诊断复发性肉瘤的能力很重要，尤其是考虑到其相关的不良预后。早期诊断和积极的多学科治疗对于改善患者的发病率和死亡率至关重要。在本病例中，放射性骨肉瘤的诊断使得我们的患者能够加快检查并接受初步的积极挽救生命的治疗。
