Management dilemmas in radiation associated pelvic sarcoma.

The rare occurrence of radiation associated sarcoma (RAS) is well known but the therapeutic benefit of initial radiotherapy for most cancers far outweighs the very small (0.03-0.2%) risk of RAS. The vast majority of second primary solid tumours after radiation are sarcomas of bone and soft tissues and occur after a median latent period of 10 years. We present a case of radiation associated osteosarcoma of pelvic bone following radiotherapy for carcinoma cervix. Using this illustrative case we have discussed the therapeutic challenges posed in the management of such patients, clinical dilemmas and the lacunae in the literature for the management of such uncommon and difficult conditions.