title: Radiation-induced osteosarcoma 17 years after mediastinal irradiation following surgical removal of thymoma.
abstract: Radiation-induced osteosarcoma is a rare complication after irradiation of primary malignancies. In the chest wall, it is usually secondary to radiotherapy for breast cancer or lymphoma. We report a rare case of radiation-induced osteosarcoma of the sternum after mediastinal irradiation of a thymoma. A 49-year-old woman presented with a sternal tumor 17 years after surgery plus mediastinal irradiation (50 Gy) for a stage III thymoma. On biopsy, this second tumor was diagnosed as a radiation-induced osteosarcoma. Systemic survey revealed additional metastatic spread to vertebrae and pelvis. Despite intensive combination chemotherapy that initially stabilized her disease, the patient died 2 years after the diagnosis was made. Because thymoma patients receiving mediastinal irradiation are thus at additional risk of radiation-induced secondary malignancy, long-term follow-up is advisable.
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L-5, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. yskadota@thoracic.med.osaka-u.ac.jp
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kadota
authors.forename: Tomoki
authors.initials: T
authors.lastname: Utsumi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sawabata
authors.forename: Masato
authors.initials: M
authors.lastname: Minami
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001859:Bone Neoplasms / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000473:pathology; D012516:Osteosarcoma / Q000188:drug therapy / Q000209:etiology* / Q000556:secondary; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D013249:Sternum / Q000473:pathology / Q000528:radiation effects*; D013934:Thymectomy; D013945:Thymoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D013953:Thymus Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome