101
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Margo CE, Duncan WC, Rich A, Garcia E, Stricker J. Periocular Cutaneous Melanoma Arising in a Radiotherapy Field. Ophthalmic Plast Reconstr Surg 2004; 20:319-20. [PMID: 15266149 DOI: 10.1097/01.iop.0000129531.74231.df] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 78-year-old woman had a periocular cutaneous melanoma in the radiation field of a meningioma. A medial canthal melanoma arose 32 years after primary radiation for a sphenoid wing meningioma and 22 years after supplemental radiation for meningioma recurrence. Histologic sections taken from skin surrounding the melanoma showed widespread melanocytic atypia and 2 separate foci of melanoma in situ. Cutaneous melanoma can arise in a radiation field after a long latency period and should be considered an uncommon form of secondary malignancy.
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102
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Kadasheva AB, Cherekaev VA, Kozlov AV, Belov AI, Zaĭtsev AM, Kudriavtseva PA. [Meningiomas of the wings of the basilar bone in patients undergone a course of radiation therapy for retinoblastoma in infancy (analysis of 3 cases)]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2004:24-7; discussion 27. [PMID: 15490635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The paper presents 3 cases of radio-induced meningiomas in patients who underwent irradiation for retinoblastoma in infancy. Meningiomas of the middle cranial fossa were diagnosed in women aged 16, 34, and 47 years. Radiation therapy was in the complex treatment of retinoblastoma in all patients in infancy (4 months to 3 years). The latent period between the irradiation and diagnosis of meningioma was 15 to 44 years. The location of detected meningiomas (the wings of the basilar bone on the side of exenteration or enucleation) corresponded to the irradiation fields. Surgical treatment yielded good results. Histological study has indicated that meningiomas were fibroblastic in the former two cases and atypical meningioma was verified in the third case when the tumor infitratively spread. Our observations support the fact that there may be radio-induced meningiomas in the area exposed to irradiation.
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103
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Mohammadianpanah M, Gramizadeh B, Omidvari S, Mosalaei A. Radiation-induced chondrosarcoma of the maxilla 7-year after combined chemoradiation for tonsillar lymphoma. J Postgrad Med 2004; 50:200-1. [PMID: 15377806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Radiation-induced sarcoma is a rare complication of radiation therapy. We report a case of radiation-induced chondrosarcoma of the maxilla. An 80-year-old Persian woman developed radiation-induced chondrosarcoma of the left maxilla 7 years after combined chemotherapy and external beam radiation therapy for the Ann Arbor stage IE malignant lymphoma of the right tonsil. She underwent suboptimal tumour resection and died due to extensive locoregional disease 8 months later. An English language literature search of Medline using the terms chondrosarcoma, radiation-induced sarcoma and maxilla revealed only one earlier reported case. We describe the clinical and pathological features of this case and review the literature on radiation-induced sarcomas.
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MESH Headings
- Aged
- Aged, 80 and over
- Chondrosarcoma/diagnosis
- Chondrosarcoma/etiology
- Chondrosarcoma/surgery
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/radiotherapy
- Maxillary Neoplasms/diagnosis
- Maxillary Neoplasms/etiology
- Maxillary Neoplasms/surgery
- Neoplasms, Radiation-Induced/diagnosis
- Neoplasms, Radiation-Induced/etiology
- Neoplasms, Radiation-Induced/surgery
- Time Factors
- Tonsillar Neoplasms/drug therapy
- Tonsillar Neoplasms/radiotherapy
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104
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Cha C, Antonescu CR, Quan ML, Maru S, Brennan MF. Long-term results with resection of radiation-induced soft tissue sarcomas. Ann Surg 2004; 239:903-9; discussion 909-10. [PMID: 15166970 PMCID: PMC1356299 DOI: 10.1097/01.sla.0000128686.51815.8b] [Citation(s) in RCA: 128] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Radiation therapy is increasingly used as adjuvant treatment of many childhood and adult malignancies. Radiation-induced sarcoma is a well recognized if uncommon event. The objective of this study is to determine the prevalence and long-term outcome for patients who develop radiation-induced sarcomas. METHODS From July 1982 to December 2001, 4884 adult patients with sarcoma were admitted and treated at our institution and recorded in a prospective database. There were 123 (2.5%) patients who had radiation-induced soft tissue sarcomas. Survival was determined by Kaplan-Meier analysis. Patient, tumor, and treatment characteristics were tested for their prognostic significance by log rank and the Cox proportional hazards model. RESULTS The median interval between radiation and development of sarcoma was 103 (6 to 534) months. In 114 patients with radiation-induced sarcoma who underwent curative resection, the 5-year actuarial survival was 41%, with a median survival of 48 months at a median follow-up of 36 months for survivors. The most common malignancy for which radiation was used was breast cancer (29%), followed by lymphoma (16%) and prostate cancer (15%). Malignant fibrous histiocytoma (23%) was the most common histologic diagnosis, followed by fibrosarcoma (15%) and angiosarcoma (15%). High-grade tumors (n = 85; 79%), age > 60 years (n = 61; 50%), and gross positive resection margin (n = 36; 32%) were predictive of poor sarcoma-specific survival on univariate and multivariate analysis. CONCLUSIONS The increasing utilization of adjuvant radiation therapy, especially for early-stage breast cancer mandates long-term follow-up to detect radiation-induced sarcoma. Surgical resection remains the primary therapy, but 5-year survival remains approximately 40%.
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105
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Loos B, Kopp J, Bach A, Kneser U, Polykandriotis E, Hohenberger W, Horch RE. [Salvage of exposed alloplastic materials in irradiated wounds - a case report]. Zentralbl Chir 2004; 129 Suppl 1:S133-6. [PMID: 15168311 DOI: 10.1055/s-2004-822642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Modern multimodal concepts of complex reconstructions and advanced wound management enlarge strategies for surgical oncological therapies. One of the mainstays of classical surgical therapy in case of exposed alloplastic materials in irradiated wounds was to remove the foreign body due to the risk of infection. This loss of integrity and function of the contaminated host bed was to allow wound healing and closure. METHOD We report the management of a 56-year-old female patient who developed a lyomyosarcoma at her left shoulder girdle 8 years after radiation of the left thorax because of breast cancer. After radical tumor resection and exarticulation of her left arm in the shoulder joint a necrosis of the soft tissue envelope developed, leading to an exposed alloplastic mesh. Staged debridement and continuous application of negative pressure was performed three times. Ultimate plastic coverage was performed by means of a pectoralis myocutaneous island flap from the other breast. RESULTS After staged debridement and repeated vacuum application excellent wound cleaning, neovascularisation, wound contraction and formation of granulation tissue within the previously irradiated tissue zone was observed. Until fourteen months postoperative wound coverage remained stable and no signs of infection were observed. DISCUSSION By means of negative pressure therapy even in radiated wounds excellent wound cleaning and sufficient formation of granulation tissue can be achieved. In some cases negative pressure therapy together with staged debridement allows reintegration of exposed and therefore potentially contaminated alloplastic meshes into new formed granulation tissue in radiated wounds respectively radiation ulcers. Thus leading to the possibility of ultimate plastic coverage.
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106
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Hogewind BF, Boutkan HB, de Jager-Nowak HK, Merkus JW. [Angiosarcoma following breast-conserving therapy]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 2004; 148:995-7. [PMID: 15181725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Two women with breast cancer, 59 and 72 years of age, were treated by means of breast-conserving surgery and radiotherapy. At the age of 66 and 77, respectively, discolouration of the skin was seen in the treated breast. Punch biopsy did not show secondary malignancy. Diagnostic (deeper) excisional biopsy revealed angiosarcoma. Ablation of the breast was performed in both patients. The younger woman, however, had a recurrence four months later that was treated with wide local excision and omentum-plasty. The older woman died two years after the ablation as a result of haematogenous metastases. Knowledge of the symptoms and diagnostic pitfalls of radiotherapy-induced angiosarcoma after breast-conserving treatment is important in the follow-up of breast-cancer patients. Histological diagnosis of a biopsy taken at sufficient depth is indicated when a secondary angiosarcoma is suspected.
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MESH Headings
- Aged
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Combined Modality Therapy
- Fatal Outcome
- Female
- Hemangiosarcoma/diagnosis
- Hemangiosarcoma/pathology
- Hemangiosarcoma/surgery
- Humans
- Mastectomy, Segmental
- Middle Aged
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/pathology
- Neoplasms, Radiation-Induced/diagnosis
- Neoplasms, Radiation-Induced/pathology
- Neoplasms, Radiation-Induced/surgery
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/surgery
- Postoperative Complications
- Radiotherapy, Adjuvant/adverse effects
- Reoperation
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107
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Misago N, Ogusu Y, Narisawa Y. Keloidal basal cell carcinoma after radiation therapy. Eur J Dermatol 2004; 14:182-5. [PMID: 15246946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
We report a case of keloidal basal cell carcinoma (BCC) that developed after radiation therapy. A 67-year-old Japanese man had received radiation therapy of an unknown amount for three years for the treatment of right cervical lymph node tuberculosis at the age of 7. Within the area of chronic radiation dermatitis, on the right preauricular region, he presented with a skin-colored to erythematous, firm nodule. Histopathologically, this nodule showed features of keloidal BCC. The stroma characteristically demonstrated the prominent, keloidal, thickened collagen bundles standing out against the surrounding actinic-damaged dermis, and well-circumscribed, keloidal collagen bundles that proliferated in a nodular form almost corresponding to a clinically firm, nodular lesion. There was no radiation fibrosis around the keloidal BCC. We discuss the differences between keloidal BCC and morpheiform BCC, and consider keloidal BCC to be a rare variant of BCC from a clinico- pathological basis.
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MESH Headings
- Aged
- Carcinoma, Basal Cell/diagnosis
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/pathology
- Carcinoma, Basal Cell/surgery
- Cheek
- Diagnosis, Differential
- Humans
- Keloid/pathology
- Keloid/surgery
- Male
- Neoplasms, Radiation-Induced/diagnosis
- Neoplasms, Radiation-Induced/etiology
- Neoplasms, Radiation-Induced/pathology
- Neoplasms, Radiation-Induced/surgery
- Skin Neoplasms/diagnosis
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Tuberculosis, Lymph Node/radiotherapy
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108
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Deutsch M, Werner R. Angiosarcoma of the breast with delay in diagnosis. CLINICAL ADVANCES IN HEMATOLOGY & ONCOLOGY : H&O 2004; 2:320; discussion 321. [PMID: 16163199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
MESH Headings
- Angiogenesis Inhibitors/administration & dosage
- Angiogenesis Inhibitors/therapeutic use
- Antineoplastic Agents, Phytogenic/administration & dosage
- Antineoplastic Agents, Phytogenic/therapeutic use
- Biopsy
- Breast Neoplasms/diagnosis
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma/radiotherapy
- Carcinoma/surgery
- Diagnosis, Differential
- Early Diagnosis
- False Negative Reactions
- Fatal Outcome
- Female
- Hemangiosarcoma/diagnosis
- Hemangiosarcoma/drug therapy
- Hemangiosarcoma/pathology
- Hemangiosarcoma/surgery
- Humans
- Lymph Node Excision
- Mastectomy, Segmental
- Middle Aged
- Neoplasms, Radiation-Induced/diagnosis
- Neoplasms, Radiation-Induced/drug therapy
- Neoplasms, Radiation-Induced/pathology
- Neoplasms, Radiation-Induced/surgery
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/surgery
- Paclitaxel/administration & dosage
- Paclitaxel/therapeutic use
- Pigmentation Disorders/diagnosis
- Pigmentation Disorders/etiology
- Pigmentation Disorders/pathology
- Radiodermatitis/diagnosis
- Radiodermatitis/pathology
- Radiotherapy, Adjuvant/adverse effects
- Telangiectasis/diagnosis
- Telangiectasis/etiology
- Telangiectasis/pathology
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109
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Ware ML, Cha S, Gupta N, Perry VL. Radiation-induced atypical meningioma with rapid growth in a 13-year-old girl. J Neurosurg Pediatr 2004; 100:488-91. [PMID: 15287460 DOI: 10.3171/ped.2004.100.5.0488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This case illustrates the potential growth rate of an atypical meningioma in a pediatric patient, emphasizes one of the potential risks after therapeutic radiation, and underscores the importance of clinical evaluation and follow up of the symptomatic patient after tumor resection and radiation therapy. The authors report a case of a radiation-induced atypical meningioma of the olfactory groove in a 13-year-old girl who received 36 Gy of radiation to the craniospinal axis and 72 Gy to the primary site of a primitive neuroectodermal epithelial tumor of the left parietooccipital lobe when she was 4 years of age. This tumor was not present on routine magnetic resonance imaging performed 13 months prior to the discovery of this lesion or on computerized tomography scanning obtained 6 months prior to the discovery of this tumor. At the time of its discovery, the tumor was 5 x 5 x 4 cm. This tumor was resected and the patient's symptoms improved. This case illustrates the importance of continued close follow up after cranial irradiation in the pediatric population.
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110
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Sanno N, Hayashi S, Shimura T, Maeda S, Teramoto A. Intracranial osteosarcoma after radiosurgery--case report. Neurol Med Chir (Tokyo) 2004; 44:29-32. [PMID: 14959934 DOI: 10.2176/nmc.44.29] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 56-year-old woman presented with an intracranial osteosarcoma at the site of previous radiosurgery, manifesting as sudden onset of headache and left hemiparesis with aphasia. She had a previous history of stereotactic radiosurgery for an intracranial tumor under a diagnosis of falx meningioma. Computed tomography showed intratumoral and peritumoral hemorrhage at the right parietofrontal region. Gross total resection of the tumor with hematoma was performed. The histological diagnosis was osteosarcoma. Sarcomatous change is a rare complication of radiotherapy. This case illustrates that osteosarcoma may develop years after radiosurgery for benign brain neoplasm.
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111
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Maalej M, Frikha H, Kochbati L, Bouaouina N, Sellami D, Benna F, Gargouri W, Dhraief S, Nasr C, Daoud J, Hajji M, Fazaa B, Souissi R, Mokhtar I, Kamoun MR. Radio-induced malignancies of the scalp about 98 patients with 150 lesions and literature review. Cancer Radiother 2004; 8:81-7. [PMID: 15063875 DOI: 10.1016/j.canrad.2003.12.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2003] [Revised: 12/16/2003] [Accepted: 12/19/2003] [Indexed: 11/23/2022]
Abstract
INTRODUCTION - The induction of malignant diseases is one of the most concerning late effects of ionizing radiation. The topic of this study deals with skin tumors developed in the irradiated areas in children given X-ray therapy for tinea capitis. MATERIAL AND METHODS - All patients with malignant tumors of the scalp referred to Salah Azaiz Institute between 1970 and 2001 have been questioned in order to determine if there had been a prior X-ray irradiation for tinea capitis, its modality, and its consequences. The first scalp irradiation goes back to 1922 and the last was performed in 1963. RESULTS - Ninety-eight patients with 150 radio-induced cancers of the scalp following irradiation for tinea capitis are reported (1.5 lesion per patient). The patients were irradiated in various hospitals and dispensaries throughout the country. Eighty-one patients (82%) had only one session of radiation. The average age at irradiation was 12 (+/-6) years, the latent period for radiation-induced skin cancers was 36 (+/-14) years. In 61 patients (62%), the scalp appeared normal and in 38% radiodermatitis was noted. Patient age at diagnosis of malignancy varied from 20 to 83 years with an average of 47 years. Basal cell carcinomas (125 cases) and spinocellular carcinomas (16 cases) were the most common, three other cases of annexial tumors, two malignant non-Hodgkin's lymphomas and four melanoma lesions are also present. Radiotherapy was used for the treatment of 74 patients (alone in 42 and associated with surgery in 32 patients); 14 patients had exclusive surgical excision. CONCLUSIONS - Basal cell carcinomas are the most frequent tumors arising on chronic radiodermatitis. In spite of the long latency period, patients' young age at irradiation explained the occurrence of these cancers at a relatively young age. Literature review is suggesting recessive mutation of tumor-suppressor genes as the characteristic abnormality in radio-induced cancer.
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MESH Headings
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Brachytherapy
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/radiotherapy
- Carcinoma, Basal Cell/surgery
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/surgery
- Child
- Combined Modality Therapy
- Head and Neck Neoplasms/etiology
- Humans
- Middle Aged
- Neoplasms, Radiation-Induced/etiology
- Neoplasms, Radiation-Induced/radiotherapy
- Neoplasms, Radiation-Induced/surgery
- Radiodermatitis/etiology
- Radiotherapy/adverse effects
- Scalp
- Skin Neoplasms/etiology
- Time Factors
- Tinea Capitis/radiotherapy
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112
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Mut M, Cataltepe O, Söylemezoğlu F, Akalan N, Ozgen T. Radiation-induced malignant triton tumor associated with severe spinal cord compression. Case report and review of the literature. J Neurosurg 2004; 100:298-302. [PMID: 15029921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Malignant triton tumor (MTT) is a variant of malignant peripheral nerve sheath tumors. The authors report a case of radiation-induced MTT in a patient with severe cervicothoracic cord compression and review the related literature. This 36-year-old man presented with pain and weakness in his left arm. His medical history was significant for a biopsy procedure involving the sampling of an aneurysmal bone cyst located at T1-3 near the left lung apex; this was performed 6 years prior to presentation and was followed by radiotherapy. Neurological examination demonstrated radicular findings involving the left C-8 and T-1 nerve roots. Neuroimaging studies revealed a large mass lesion extending from C-6 to T-2 along the vertebral column, invading the upper thoracic cavity and the adjacent lung apex, and infiltrating the paravertebral muscles. A subtotal resection was performed, but the tumor regrew extensively within a short time. It invaded the spinal canal and caused significant cord compression. The patient underwent surgery two more times for tumor debulking and to relieve progressive airway and spinal canal compromise. He eventually became quadriplegic, however, and died 13 months after diagnosis of MTT. This is the seventh case of radiation-induced MTT and the fifth of MTT with spinal canal involvement to be reported in the literature.
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113
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Chuo CB, Corder AP. Post-irradiation angiosarcoma of the breast. BRITISH JOURNAL OF PLASTIC SURGERY 2004; 57:177-8. [PMID: 15037181 DOI: 10.1016/j.bjps.2003.11.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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114
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Gervaz P, Hennig R, Buechler M, Soravia C, Brigstock DR, Morel P, Egger JF, Friess H. Long-term expression of fibrogenic cytokines in radiation-induced damage to the internal anal sphincter. SWISS SURGERY = SCHWEIZER CHIRURGIE = CHIRURGIE SUISSE = CHIRURGIA SVIZZERA 2004; 9:193-7. [PMID: 12974179 DOI: 10.1024/1023-9332.9.4.193] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is accumulating evidence, both quantitative and qualitative, that pelvic irradiation affects anorectal function. However, the molecular mechanisms responsible for radiation-induced damage to the anal sphincter remain unclear. AIM To determine the expression of transforming growth factor-beta 1 (TGF-beta 1) and its downstream effector connective tissue growth factor (CTGF) in the anal sphincter of a patient irradiated for prostate cancer. PATIENT A 82 year-old patient developed a rectal adenocarcinoma and underwent an abdomino-perineal resection (APR), four years after receiving pelvic irradiation for prostate carcinoma. METHODS Tissue sections of the anal sphincter were processed for histology. Immunostaining for TGF-beta 1 and CTGF were performed. RESULTS CTGF and TGF-beta 1 immunoreactivity was detected in the irradiated anal sphincter, and was absent in controls. Immunoreactivity for both cytokines predominated in the internal sphincter. CTGF and TGF-beta 1 were preferentially detected in endothelial cells, myofibroblasts and fibroblasts; in addition, there was strong immunoreactivity for TGF-beta 1, but not for CTGF in smooth muscle cells of the anal canal. CONCLUSION Four years after pelvic irradiation, radiation-induced damage appeared to affect predominantly the smooth muscle layer of the anal canal. The molecular mechanisms responsible for radiation-induced fibrosis to these tissues involve prolonged activation of TGF-beta 1 and its downstream effector CTGF.
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115
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Romanchishen AF, Cheren'ko SM, Gostimskiĭ AV, Larin AS. [Surgical treatment of sporadic and radiation-induced thyroid cancer in young patients]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 2004; 163:75-8. [PMID: 15199776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
An analysis of results of treatment of sporadic thyroid cancer in 68 children and juveniles and in 119 adult patients with radio-induced carcinomas irradiated in childhood after the Chernobyl APS accident in 1986 has revealed that the sporadic thyroid cancer in children and adults with radio-induced carcinomas are highly aggressive. For all this, radio-induced carcinomas are known to have aggressive local growth that in most cases required extended operations. The surgical treatment of carcinomas allows to get survival of the absolute majority of the patients.
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116
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Fruba J, Chustecki A, Szwedowicz P. [Laryngeal radionecrosis]. OTOLARYNGOLOGIA POLSKA 2004; 58:915-20. [PMID: 15732776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Laryngeal radionecrosis is now an uncommon, late complication after radiotherapy. The authors presented the diagnostic difficulties with differeniation beetween radionecrosis and the recurrent cancer, as well as their own experience with the treatment. The material consisted of 6 cases with radionecrosis (Chandler grade IV) surgically treated during past 15 years. In 3 cases complications occurred in a year after radiotherapy, in 2--ten years and in one--45 years later. In all cases repeated biopses were negative. Laryngeal radionecrosis is life threatening complication, that is why it requires intensive pharmacological and surgical treatment. Despite repeated negative biopses, total laryngectomy is the operation of choice when the larynx is non-functioning. In chosen cases, due to often observed postoperative complications (necrosis of the skin, pharyngeal fistula), indication is the use of artery flaps with simultaneous total laryngectomy.
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117
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Caporale A, Angelico F, Cosenza MU, Giuliani A, Del Ben M, Benvenuto E, Franchi F. A late complication of pelvic radiotherapy: leiomyosarcoma of the rectum. Report of a case and review of the literature. HEPATO-GASTROENTEROLOGY 2003; 50:1933-6. [PMID: 14696435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Leiomyosarcoma of the rectum is an uncommon malignancy; it accounts for less than 0.1% of all malignancies of the colon and rectum and only one case has been reported long-term following pelvic radiotherapy. We report a second case of leiomyosarcoma of the rectum after radiotherapy in an elderly women who received external radiation therapy eighteen years before, for endometrial carcinoma. We confirm that leiomyosarcoma may be a late uncommon effect of pelvic irradiation and suggest that close and long-term surveillance of irradiated patients is highly recommended.
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118
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Varghese BT, Ramdas K, Sebastian P, Nair MK. Salvage chemotherapy and surgery for radio recurrent carcinoma glottis. Indian J Cancer 2003; 40:113-5. [PMID: 14716115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Chemoradiotherapy is increasingly used in advanced laryngeal cancers. Failures are generally managed by surgery. They include histologically confirmed recurrent or residual disease or a symptomatic life threatening treatment sequelae. Tumour recurrence or residivism can be managed by chemotherapy when radical surgery is either refused by the patient or if the general condition of the patient do not permit it. However surgery becomes inevitable when life threatening treatment sequelae like absolute pharyngo-oesophageal stricture and aspiration sets in.
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119
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Kikuchi S, Perrier ND, Ituarte PHG, Treseler PA, Siperstein AE, Duh QY, Greenspan FS, Clark OH. Accuracy of fine-needle aspiration cytology in patients with radiation-induced thyroid neoplasms. Br J Surg 2003; 90:755-8. [PMID: 12808628 DOI: 10.1002/bjs.4198] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Fine-needle aspiration cytology (FNAC) is useful for selecting patients with thyroid nodules for thyroidectomy. Its value in patients who have been exposed to low-dose therapeutic radiation is questionable because these patients have an increased risk of multifocal benign and malignant tumours, and thyroid cancer is common in such patients. METHODS Between 1960 and 1999, 171 patients with one or more thyroid nodules who had a history of exposure to radiation underwent operation; 49 of these patients had preoperative FNAC. The cytology results in these 49 patients were compared with those of an age- and sex-matched control group of patients with thyroid nodules who did not have a history of radiation exposure. RESULTS Of those who had been exposed to radiation, six of 20 patients with 'benign' cytology by FNAC and six of 16 patients with 'suspicious' cytology had thyroid cancer. All 13 specimens considered to be malignant on FNAC were indeed malignant. There was a higher rate of false-negative cytological examinations among patients with a history of irradiation that in those without. CONCLUSION FNAC of thyroid nodules in patients with a history of irradiation is not as accurate as that in non-irradiated patients, primarily because of coexisting occult thyroid cancers.
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120
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Salvati M, Polli FM, Caroli E, Frati A, Missori P, Delfini R. Radiation-induced schwannomas of the nervous system. Report of five cases and review of the literature. J Neurosurg Sci 2003; 47:113-6; discussion 116. [PMID: 14618141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Radiation therapy has important delayed effects on the central nervous system. Prominent among these effects is radiation necrosis of nervous tissue, but an oncogenic effect is also recognized. Both benign and malignant intracranial tumors can develop in irradiated fields, particularly in children. Most of these tumors are sarcomas, meningiomas or gliomas and only occasionally schwannomas. We report 5 cases of postirradiation acoustic nerve schwannoma observed in our Department.
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Bartnes K, Isaksen V, Due J. [Surgical treatment of angiosarcomas]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2003; 123:1527-8. [PMID: 12822015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
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122
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Briccoli A, Manfrini M, Rocca M, Lari S, Giacomini S, Mercuri M. Sternal reconstruction with synthetic mesh and metallic plates for high grade tumours of the chest wall. THE EUROPEAN JOURNAL OF SURGERY = ACTA CHIRURGICA 2003; 168:494-9. [PMID: 12549692 DOI: 10.1080/110241502321116523] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To present our experience of reconstruction of the chest wall after sternectomy for high grade tumours. DESIGN Retrospective study. SETTING University hospital, Italy. SUBJECTS 18 patients who required sternectomy for high grade tumours. INTERVENTIONS After wide resection of the tumour the sternum and chest wall were reconstructed with polypropylene (Marlex) mesh and mouldable titanium plates. Pedicled muscle flaps were used to complete the reconstruction. MAIN OUTCOME MEASURES Morbidity, mortality, and outcome. RESULTS The 18 tumours were chondrosarcomas (n = 7); osteosarcomas, radiation-induced sarcomas, and local recurrences after breast cancer (n = 2 each); and angiosarcoma, Ewing sarcoma, liposarcoma, malignant fibrous histiocytoma, and metastatic renal carcinoma (n = 1 each). One patient died in hospital. Two patients developed wound infections, one required repeated aspirations of a pleural effusion, and one patient later developed loosening of the plate that had been sutured to the clavicular stump. At the time of follow-up (mean 32 months, range 12-74) 16 patients were alive, all of whom had returned to their normal life style. CONCLUSIONS The technique is easy to follow and has the advantages of a short hospital stay and good local control. It obviates the need for postoperative mechanical ventilation, and means that patients are not prevented from working because of incapacity.
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Tuncel A, Adanali G, Senen D, Erdogan B. Disseminated basal cell carcinoma. Plast Reconstr Surg 2003; 111:949-51. [PMID: 12560736 DOI: 10.1097/00006534-200302000-00090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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124
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Denoël C, Foucras L, de Lafontan B, Grolleau JL, Chavoin JP. [About an uncommon case of post-irradiation sarcoma of the chest wall]. ANN CHIR PLAST ESTH 2003; 48:36-41. [PMID: 12657333 DOI: 10.1016/s0294-1260(02)00157-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A case of postirradiation leiyomyosarcoma of the chest wall is presented. The tumor occurred after 4 episodes of radiotherapy over a period of 12 years. Criterious to define the radiation-induced sarcoma are discussed. The location of the leiomyosarcoma in comparison with the different irradiated fields shows that the tumor occurred in the border line of the differents fields called "zone of penumbra".
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Demirkan F, Unal S, Cenetoğlu S, Cinel L. Radiation-induced leiomyosarcomas as second primary tumors in the head and neck region: report of 2 cases. J Oral Maxillofac Surg 2003; 61:259-63. [PMID: 12619008 DOI: 10.1053/joms.2003.50029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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