title: Radiotherapy-induced tumors of the spine, peripheral nerve, and spinal cord: Case report and literature review.
abstract: BACKGROUND
  The development of a secondary malignancy in the field of radiation is a rare but well-recognized hazard of cancer treatment. The radiotherapy-induced (RT-I) tumors are even more aggressive and potentially lethal than the primary tumor. To goal of this article is to report a case of RT-I neural tumor located in the peripheral nerve and spinal cord and to perform a literature review of the subject.
  
  
  METHODS
  Thirty-year male with symptoms of hypoesthesia and dysesthesia of the L5 nerve root distribution and previous treatment of a testicular seminoma 20 years previously. The lumbar magnetic resonance imaging showed the growth of a nerve root tumor. Surgery was performed, and a fusiform tumor was resected with clear margins. The anatomopathological and immunohistochemical studies were compatible with a malignant peripheral nerve sheath tumor. A total of 30 cases were included in the review. The mean age of the patients at diagnosis of the induced tumor was 39.36 (±16.74) years. Most were male (63.3%). The main type of primary disease was neural tumors (30%). The most common type of histology was fibrosarcoma (20.0%). No difference was found in age, gender, and time of diagnosis between neural and nonneural tumors. The mean survival after the diagnosis of the secondary tumor was 10.7 months (±13.27), and neural tumors had a longer survival period (P = 0.031).
  
  
  CONCLUSIONS
  The current gold standard therapy is complete resection with clear margins, since most tumors do not respond to chemotherapy and RT. The neural type of RT-I tumor presented a longer survival period.
authors.affiliation: Department of Neurosurgery, University of Caxias do Sul, Caxias do Sul, RS, Brazil; Medical Faculty of University of Caxias do Sul, University of Caxias do Sul, Caxias do Sul, RS, Brazil; Cell Therapy Laboratory, University of Caxias do Sul, Caxias do Sul, RS, Brazil; Clinical Studies and Basic Models of Spinal Disorders Laboratory, University of Caxias do Sul, Caxias do Sul, RS, Brazil; Department of Neurosurgical, AOSpine, Latin America.
authors.forename: Asdrubal
authors.initials: A
authors.lastname: Falavigna
authors.affiliation: Clinical Studies and Basic Models of Spinal Disorders Laboratory, University of Caxias do Sul, Caxias do Sul, RS, Brazil.
authors.forename: Pedro Guarise
authors.initials: PG
authors.lastname: da Silva
authors.affiliation: Department of Neurosurgical, Institute of Cancer of the State of São Paulo, São Paulo, SP, Brazil.
authors.forename: William
authors.initials: W
authors.lastname: Teixeira
keywords: Malignant peripheral nerve sheath tumor; radiation-induced tumor; radiotherapy; spine; spine surgery