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放射性诱导肉瘤表现为臀部脓肿:诊断和治疗的挑战。

Radiation-induced sarcoma presenting as a gluteal abscess: a diagnostic and therapeutic challenge.

机构信息

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India.

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India

出版信息

BMJ Case Rep. 2020 Dec 13;13(12):e236601. doi: 10.1136/bcr-2020-236601.

Abstract

Sarcomas are a rare and fatal treatment complication following radiotherapy. Radiation-induced sarcomas (RISs) presenting as a gluteal abscess is a rarity, accounting for its varied presentation. We present a case of a middle-aged woman, post-chemo-radiation for carcinoma cervix 5 years ago, who presented with gluteal abscess. Achieving haemostasis post incision and drainage under anaesthesia was a challenge. On further evaluation, she was diagnosed with radiation-induced gluteal soft tissue sarcoma. Haemostasis was achieved after radiation following failed attempts of surgical and radiological interventions. She is currently planned for chemotherapy. Cancer survivors have an increased risk of developing a second malignancy following radiation treatment. RISs are highly aggressive, exhibit a varied clinical presentation and pose a challenge in early diagnosis; thus, have a poor outcome. RISs pose a diagnostic challenge; any dubious lesion in the previously irradiated field should raise suspicion and prompt aggressive management.

摘要

肉瘤是放疗后罕见且致命的治疗并发症。放射诱导肉瘤(RIS)表现为臀脓肿较为罕见,其表现多样。我们报告了 1 例中年女性病例,5 年前因宫颈癌接受化疗-放疗,现出现臀脓肿。在麻醉下切开引流后止血是一个挑战。进一步评估后,她被诊断为放射诱导性臀软组织肉瘤。在手术和放射介入治疗失败后,放射治疗后止血成功。她目前计划接受化疗。癌症幸存者在放疗后发生第二恶性肿瘤的风险增加。RIS 具有高度侵袭性,表现出多种临床表现,早期诊断困难,因此预后不良。RIS 诊断具有挑战性;任何先前照射野中可疑的病变都应引起怀疑,并促使采取积极的治疗措施。

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Radiation-Induced Sarcoma of the Head and Neck: A Review of the Literature.头颈部放射性肉瘤:文献综述
Front Oncol. 2018 Oct 17;8:449. doi: 10.3389/fonc.2018.00449. eCollection 2018.
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Imaging of radiation-associated sarcoma.放射性肉瘤的影像学表现。
AJR Am J Roentgenol. 2011 Jul;197(1):W30-6. doi: 10.2214/AJR.10.5558.
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Sarcoma arising in irradiated bone; report of 11 cases.放疗后骨组织发生的肉瘤;11例报告
Cancer. 1948 May;1(1):3-29. doi: 10.1002/1097-0142(194805)1:1<3::aid-cncr2820010103>3.0.co;2-7.
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Imaging findings of radiation-induced sarcoma of the head and neck.头颈部放射性肉瘤的影像学表现。
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