title: Radiation-induced osteosarcoma and papillary carcinoma of the thyroid.
abstract: OBJECTIVE
  This article describes a patient with dual radiation-induced malignancies after treatment of neuroblastoma.
  
  
  METHODS
  A 12-year-old boy with a history of neuroblastoma was treated with chemotherapy, I-131 MIBG, and radiotherapy at age 4. He was disease-free for 8 years, but then developed left shoulder pain resulting from osteosarcoma. A thyroid malignancy was discovered during the evaluation.
  
  
  RESULTS
  The patient was treated with thyroidectomy and then chemotherapy according to a Children's Cancer Group Study protocol.
  
  
  CONCLUSIONS
  Radiation-induced sarcoma should be suspected whenever a patient who has received radiation several years previously presents with pain or swelling in the irradiated area.
authors.affiliation: Department of South Coast Radiology, Mermaid Beach, Australia. barry.shulkin@stjude.org
authors.forename: Adam
authors.initials: A
authors.lastname: Tonakie
authors.forename: Barry L
authors.initials: BL
authors.lastname: Shulkin
authors.forename: James C
authors.initials: JC
authors.lastname: Sisson
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Yanik
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Hutchinson
mesh_terms: D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000209:etiology*; D002648:Child; D006801:Humans; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000000981:diagnostic imaging* / Q000209:etiology; D009447:Neuroblastoma / Q000532:radiotherapy / Q000628:therapy; D012516:Osteosarcoma / Q000000981:diagnostic imaging* / Q000209:etiology*; D011877:Radionuclide Imaging; D011878:Radiotherapy / Q000009:adverse effects*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology*