Ewing's sarcoma. Radiographic pattern of healing and bony complications in patients with long-term survival.
The radiographic appearance of Ewing's sarcoma was studied retrospectively in 22 patients who survived 5 years or longer after diagnosis and treatment. Expected changes from treatment, including regression of the extraosseous soft tissue mass, periostitis, and reconstitution of the cortex, occurred in all patients. Local recurrence occurred in one patient 10 years after complete remission whereas secondary osteosarcoma occurred more than 5 years after complete remission in two other cases. Both recurrent and secondary tumors presented as new lytic foci at the site of the original primary lesion. Lytic changes from radiation (radiation osteitis) may develop more than 2 years after treatment and in this sample; such findings were widely distributed in the radiation port. The authors conclude that bone remodeling and postradiation changes occur slowly over 2 years after treatment, and that any localized lysis at the primary site is suspicious for recurrence or secondary neoplasm. Knowledge of the expected changes and patterns of local recurrence and secondary neoplasms helps one to detect any significant change in its early phase.
Ehara
S
S
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Kattapuram
S V
SV
Egglin
T K
TK
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000528:radiation effects*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009378:Neoplasms, Multiple Primary / Q000209:etiology; D012516:Osteosarcoma / Q000209:etiology; D011859:Radiography; D012074:Remission Induction; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy