Osteogenic sarcoma after orbital radiation rhabdomyosarcoma.
OBJECTIVE
We describe the occurrence of maxillary and orbital osteogenic sarcoma in a child after treatment of contralateral orbital rhabdomyosarcoma with external beam radiation and chemotherapy.


METHODS
Interventional case report.


METHODS
Treatment of a maxillary and orbital rhabdomyosarcoma with surgical resection, systemic chemotherapy, and local radiation.


METHODS
Occurrence and histology of secondary malignancy after orbital radiation.


RESULTS
An eleven year-old male presented for evaluation of left facial swelling, occurring ten years after successful treatment of a right orbital embryonal rhabdomyosarcoma with chemotherapy and 5040 cGY of external beam radiation. Computerized tomography demonstrated a mass involving the left maxillary sinus and orbital floor. Biopsy demonstrated osteogenic sarcoma. Despite attempted total excision with radical maxillectomy, resection margins were found to have microscopic extension of the tumor. Postoperatively he was treated with systemic chemotherapy and local radiation. Eight months postoperatively he remains alive despite local progression.


CONCLUSIONS
Osteogenic sarcoma can occur as a secondary malignancy years after the successful treatment of orbital rhabdomyosarcoma with external beam radiation and chemotherapy. After orbital radiation, subjects should undergo routine lifelong examinations.
Yip
Chee-Chew
CC
Department of Ophthalmology, The Cincinnati Eye Institute and The University of Cincinnati College of Medicine, Barrett Center-0670, 242 Goodman Street, Cincinnati, OH 45219-2316, USA.
Kersten
Robert C
RC
McCulley
Timothy J
TJ
Ballard
Edgar T
ET
Kulwin
Dwight R
DR
D002648:Child; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D009918:Orbital Neoplasms / Q000209:etiology* / Q000473:pathology / Q000532:radiotherapy*; D012516:Osteosarcoma / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D012208:Rhabdomyosarcoma / Q000473:pathology / Q000532:radiotherapy*; D014057:Tomography, X-Ray Computed