J Wood1, J Ver Halen2, S Samant1, N Florendo3. 1. Department of Otolaryngology/Head and Neck Surgery,University of Tennessee Health Science Center,Memphis,Tennessee,USA. 2. Department of Plastic and Reconstructive Surgery,Baptist Cancer Center,Memphis,Tennessee,USA. 3. Department of Pathology,University of Tennessee Health Science Center,Memphis,Tennessee,USA.
Abstract
BACKGROUND: Radiation therapy is a commonly used treatment in head and neck oncology, whether used alone or as an adjunct to other treatments. Osteoradionecrosis and radiation-induced malignancy are both rare, late complications of radiation therapy. METHODS: This paper describes a case of radiation-induced sarcoma of the mandible initially presenting as osteoradionecrosis. In addition, the literature on the identification and treatment of these entities is reviewed. RESULTS: The patient underwent excision and reconstruction of the presumed osteoradionecrosis. Final pathology demonstrated radiation-induced sarcoma. The patient suffered tumour recurrence at seven months post-operatively. CONCLUSION: When evaluating a patient with osteoradionecrosis, clinicians should be cognisant of the risk of malignancy. This paper describes the first case of radiation-induced sarcoma presenting as osteoradionecrosis. Primary treatment of radiation-induced sarcoma is wide surgical extirpation, with a very limited role for chemotherapy. Overall survival for this entity is poor.
BACKGROUND: Radiation therapy is a commonly used treatment in head and neck oncology, whether used alone or as an adjunct to other treatments. Osteoradionecrosis and radiation-induced malignancy are both rare, late complications of radiation therapy. METHODS: This paper describes a case of radiation-induced sarcoma of the mandible initially presenting as osteoradionecrosis. In addition, the literature on the identification and treatment of these entities is reviewed. RESULTS: The patient underwent excision and reconstruction of the presumed osteoradionecrosis. Final pathology demonstrated radiation-induced sarcoma. The patient suffered tumour recurrence at seven months post-operatively. CONCLUSION: When evaluating a patient with osteoradionecrosis, clinicians should be cognisant of the risk of malignancy. This paper describes the first case of radiation-induced sarcoma presenting as osteoradionecrosis. Primary treatment of radiation-induced sarcoma is wide surgical extirpation, with a very limited role for chemotherapy. Overall survival for this entity is poor.
Authors: Andrés Coca-Pelaz; Antti A Mäkitie; Primož Strojan; June Corry; Avraham Eisbruch; Jonathan J Beitler; Sandra Nuyts; Robert Smee; Johannes A Langendijk; William M Mendenhall; Cesare Piazza; Alessandra Rinaldo; Alfio Ferlito Journal: Adv Ther Date: 2020-11-13 Impact factor: 3.845