Post-radiation sarcoma of the neck treated with re-irradiation followed by wide excision
نویسندگان
چکیده
BACKGROUND Post-radiation sarcoma (PRS) is an uncommon disease manifesting as sarcoma in a previously irradiated field, usually with a latent period of 5 years or more. Literature is limited to small series. Optimal management of this disease is unclear. Positive margins are common following attempted curative surgery and outcomes are poor. Radiotherapy is hardly used and its effect on PRS is not known. We described a case of PRS treated with preoperative radiotherapy followed by margin-negative wide excision. CASE PRESENTATION The 59-year-old patient presented with a mass in the left supraclavicular fossa and numbness in the arm, six years following radical irradiation of the head and neck for nasopharyngeal carcinoma. Open biopsy showed pleomorphic spindle cell sarcoma. She was treated with pre-operative hyperfractionated radiotherapy followed by margin-negative wide excision and nerve grafting. Cumulative radiation dose to the supraclavicular fossa was 98 Gy. Histological examination of the post-irradiation tumor specimens showed evidence of significant tumor response to re-irradiation. The patient remained free of disease five years after surgery with excellent functional outcome. CONCLUSION Role of radiotherapy in PRS is uncertain. We described a case that was successfully managed with preoperative radiotherapy and margin-negative wide excision in terms of tumor control and functional outcomes. The impact of radiotherapy was demonstrated in the post-irradiation resected specimen. Further investigation using re-irradiation and surgery in PRS is warranted.
منابع مشابه
Re-irradiation of metastatic disease in the neck from xeroderma pigmentosum.
BACKGROUND Xeroderma pigmentosum, an autosomal recessive disease that occurs with a frequency of 1:250,000, is caused by a genetic defect in nucleotide excision repair enzymes. Mutation of these enzymes leads to the development of multiple basal cell and squamous cell carcinomas. OBJECTIVES We present a case of xeroderma pigmentosum in a patient with cervical and intraparotid metastatic disea...
متن کاملSoft Tissue Necrosis in Head and Neck Cancer Patients After Transoral Robotic Surgery or Wide Excision With Primary Closure Followed by Radiation Therapy: Erratum
متن کامل
Sinonasal Teratocarcinosarcoma Report of a case
Sinonasal teratocarcinosarcoma (SNTCS) is a rare tumor characterized by mixture architecture of epithelial and mesenchymal components. SNTCS is a highly malignant tumor displaying progressive and aggressive growth with poor prognosis. Only about 40% of all patients survive after five years. It seems the combination of surgery and radiotherapy currently is the most effective treatment. In this r...
متن کاملSynovial Sarcoma of the Head and Neck: A Case of Childhood Soft Tissue Sarcoma
Although rare, synovial sarcoma is the most common malignant non-rhabdomyosarcomatous soft tissue sarcoma in children and adolescents. Synovial sarcoma typically involves the soft tissues of the extremities, especially near large joints, but it can occur anywhere in the body in locations far from joint spaces. Although this tumor typically affects adults in their fourth decade of life, nearly h...
متن کاملEvaluation of changes in excision cavity volume during whole breast irradiation using secondary CT image
Background: The aim of this study was to evaluate the reduction in excision cavity volume (ECV) during the whole breast radiotherapy (WBRT). The delineating of reduced cavity volume on secondary CT (computed tomography) might decrease the field size of boost plan. Materials and Methods: Twenty patients were treated having breast conservative surgery. At first, primary CT simulation (CT-1) was d...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- World Journal of Surgical Oncology
دوره 4 شماره
صفحات -
تاریخ انتشار 2006