Radiation-induced sarcomas (RIS) are rare but severe long-term complications of radiotherapy (RT). They typically arise years after exposure to ionizing radiation used to treat primary malignancies and complicate pati...Radiation-induced sarcomas (RIS) are rare but severe long-term complications of radiotherapy (RT). They typically arise years after exposure to ionizing radiation used to treat primary malignancies and complicate patient outcomes. Determining the risk associated with these radiation-induced cancers is challenging due to confounding factors such as lifestyle and genetic predisposition. Liposarcomas, which are the most common type of soft tissue sarcomas, originate from adipose tissue and can develop as a late complication of RT. Although they account for a significant portion of soft tissue sarcomas, radiation-induced liposarcomas are still considered rare, making them a noteworthy diagnostic and therapeutic concern. In this report, we present a rare case of radiation-induced dedifferentiated liposarcoma arising 12 years after RT for vulvar cancer. The patient presented with a mass in the groin, which was initially suspected to be a local recurrence. Imaging studies revealed a suspicious lesion on PET/CT, while MRI showed no significant findings. Histopathological evaluation confirmed the diagnosis of dedifferentiated liposarcoma. Surgical resection was performed with a focus on achieving negative margins. A literature review identified nine similar cases, with five being pleomorphic liposarcomas. The average time to presentation was 15 years (interval 3 - 47 years), with a mean radiation dose of 62 Gy. This case highlights the importance of long-term follow-up for cancer survivors and the need for vigilance in diagnosing secondary malignancies following RT.展开更多
Patients with recurrent breast cancer to chest wall, who had previous irradiation, are difficult to manage and have limited options. Several reports described the use of photon therapy, hyperthermia, and brachytherapy...Patients with recurrent breast cancer to chest wall, who had previous irradiation, are difficult to manage and have limited options. Several reports described the use of photon therapy, hyperthermia, and brachytherapy. This is a case report of a 72-year-old female with Stage IIIA (pT3N1M0) invasive ductal carcinoma of the right breast status post modified radical mastectomy. The patient developed recurrence to the chest wall and one internal mammary lymph node one year later. She received 3-D conformal photon radiation therapy for this recurrence. Two years later, she had progression of the recurrence at the right chest wall and axillary and internal mammary lymph nodes. She was treated with intensity modulated proton therapy (IMPT) for a total of 6600 cGy in 33 fractions. However, four months later, she was found to have biopsy-proven isolated metastatic disease at her right bicep, which was again treated with IMPT for a dose of 6000 cGy in 20 fractions. Proton beam therapy was used in this case to spare dose to the brachial plexus, heart and lung while optimally irradiating the recurrent tumors. At last follow up, the patient is alive and has been disease free for 39 months. This report describes the technique and dosimetry for this unique case, which also reviewed recent series of re-irradiation using proton beam.展开更多
文摘Radiation-induced sarcomas (RIS) are rare but severe long-term complications of radiotherapy (RT). They typically arise years after exposure to ionizing radiation used to treat primary malignancies and complicate patient outcomes. Determining the risk associated with these radiation-induced cancers is challenging due to confounding factors such as lifestyle and genetic predisposition. Liposarcomas, which are the most common type of soft tissue sarcomas, originate from adipose tissue and can develop as a late complication of RT. Although they account for a significant portion of soft tissue sarcomas, radiation-induced liposarcomas are still considered rare, making them a noteworthy diagnostic and therapeutic concern. In this report, we present a rare case of radiation-induced dedifferentiated liposarcoma arising 12 years after RT for vulvar cancer. The patient presented with a mass in the groin, which was initially suspected to be a local recurrence. Imaging studies revealed a suspicious lesion on PET/CT, while MRI showed no significant findings. Histopathological evaluation confirmed the diagnosis of dedifferentiated liposarcoma. Surgical resection was performed with a focus on achieving negative margins. A literature review identified nine similar cases, with five being pleomorphic liposarcomas. The average time to presentation was 15 years (interval 3 - 47 years), with a mean radiation dose of 62 Gy. This case highlights the importance of long-term follow-up for cancer survivors and the need for vigilance in diagnosing secondary malignancies following RT.
文摘Patients with recurrent breast cancer to chest wall, who had previous irradiation, are difficult to manage and have limited options. Several reports described the use of photon therapy, hyperthermia, and brachytherapy. This is a case report of a 72-year-old female with Stage IIIA (pT3N1M0) invasive ductal carcinoma of the right breast status post modified radical mastectomy. The patient developed recurrence to the chest wall and one internal mammary lymph node one year later. She received 3-D conformal photon radiation therapy for this recurrence. Two years later, she had progression of the recurrence at the right chest wall and axillary and internal mammary lymph nodes. She was treated with intensity modulated proton therapy (IMPT) for a total of 6600 cGy in 33 fractions. However, four months later, she was found to have biopsy-proven isolated metastatic disease at her right bicep, which was again treated with IMPT for a dose of 6000 cGy in 20 fractions. Proton beam therapy was used in this case to spare dose to the brachial plexus, heart and lung while optimally irradiating the recurrent tumors. At last follow up, the patient is alive and has been disease free for 39 months. This report describes the technique and dosimetry for this unique case, which also reviewed recent series of re-irradiation using proton beam.
