Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Center for Pediatric Oncology and Hematology, Vilnius University, 08406 Vilnius, Lithuania.
Medicina (Kaunas). 2020 Mar 31;56(4):155. doi: 10.3390/medicina56040155.
Radiation-induced sarcoma (RIS) has been reported as a late secondary malignancy following radiotherapy for various types of cancer with a median latency of 10 years. We describe an early RIS that developed in an adolescent within three years of treatment (including PD-L1 check-point inhibitor Nivolumab) of a relapsed classic Hodgkin lymphoma (HL) and was diagnosed post-mortem. The patient died of the progressive RIS that was misleadingly assumed to be a resistant HL based on the positive PET/CT scan. Repetitive tumor biopsies are warranted in cases of aggressive and multi-drug resistant HL to validate imaging findings, ensure correct diagnosis and avoid overtreatment.
放疗后肉瘤（RIS）是一种在接受各种类型癌症放疗后发生的迟发性第二原发恶性肿瘤，潜伏期中位数为 10 年。我们描述了一例青少年 RIS，其在接受复发经典霍奇金淋巴瘤（HL）治疗（包括 PD-L1 检查点抑制剂 Nivolumab）后三年内发生，且在死后确诊。该患者死于进行性 RIS，正电子发射断层扫描（PET/CT）显示疾病进展，基于该检查结果，HL 被误诊为耐药，患者因此死亡。在侵袭性和多药耐药 HL 病例中，需要重复肿瘤活检以验证影像学发现，确保正确诊断，避免过度治疗。
