ABSTRACT
PURPOSE: To report 2 interventional cases of dedifferentiated chondrosarcoma with orbital involvement after radiotherapy performed in childhood and to review the literature on chondrosarcoma in the orbit following radiation treatment. METHODS: Retrospective analysis of medical records of 2 patients with chondrosarcoma of the orbits with review of the literature. RESULTS: The first patient developed chondrosarcoma of the orbital and maxillary sinus 36 years after external beam radiation therapy to the OS to treat retinoblastoma. The second patient developed a large orbital chondrosarcoma 35 years after external beam radiation therapy in the treatment of craniofacial fibrous dysplasia. CONCLUSIONS: These cases highlight the risk of secondary chondrosarcoma in patients following radiotherapy and the importance of lifetime monitoring.
Subject(s)
Chondrosarcoma/etiology , Cobalt Radioisotopes/adverse effects , Facial Bones/pathology , Neoplasms, Radiation-Induced/etiology , Orbital Neoplasms/pathology , Skull Neoplasms/etiology , Adult , Cell Dedifferentiation , Chondrosarcoma/diagnosis , Fatal Outcome , Female , Fibrous Dysplasia of Bone/radiotherapy , Humans , Infant , Magnetic Resonance Imaging , Male , Neoplasm Invasiveness , Neoplasms, Radiation-Induced/diagnosis , Orbital Neoplasms/diagnostic imaging , Retinal Neoplasms/radiotherapy , Retinoblastoma/radiotherapy , Skull Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
A consensus on the clinical course of fibrous dysplasia has not yet emerged in the literature. We retrospectively evaluated 36 patients who were diagnosed with fibrous dysplasia in our institution and were followed for a mean duration of 56.5 months (range 7-210 months). Their mean age was 25.8 years (range 5-67 years); 46.7% were male. The most frequent presenting complaints were pain (66% of patients) and pathological fracture (20%). Osteosarcoma developed in one patient 20 years after he had undergone radiation therapy for fibrous dysplasia in the tibia. Mazabraud syndrome was encountered in two patients, and aneurysmal bone cyst associated with fibrous dysplasia was seen in one patient. Fibrous dysplasia is generally considered a static disease, but with long-term follow-up it is found to have a more dynamic nature. For this reason, patients with fibrous dysplasia should be followed carefully over the long-term.
Subject(s)
Fibrous Dysplasia of Bone/surgery , Adolescent , Adult , Aged , Bone Cements/therapeutic use , Bone Cysts, Aneurysmal/etiology , Bone Neoplasms/etiology , Bone Transplantation , Child , Child, Preschool , Curettage , Female , Fibrous Dysplasia of Bone/complications , Fibrous Dysplasia of Bone/radiotherapy , Follow-Up Studies , Fractures, Spontaneous/etiology , Humans , Male , Middle Aged , Myxoma/pathology , Neoplasms, Radiation-Induced/etiology , Osteosarcoma/etiology , Retrospective Studies , Soft Tissue Neoplasms/pathology , SyndromeABSTRACT
Sarcoma arising from fibrous dysplasia (FD) is rare and it is more common in polyostotic type. In this case report, we present a 41-year-old male patient who developed osteosarcoma of the left tibia 28 years after the initial diagnosis and 20 years after radiation therapy for FD. He underwent above-knee amputation, but died eight months after surgery. This case suggests that radiotherapy has no beneficial effect in the treatment of FD and that it may be associated with the development of sarcoma.
Subject(s)
Bone Neoplasms/diagnosis , Fibrous Dysplasia of Bone/radiotherapy , Neoplasms, Radiation-Induced/diagnosis , Osteosarcoma/diagnosis , Tibia , Adult , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/etiology , Diagnosis, Differential , Humans , Male , Neoplasms, Radiation-Induced/diagnostic imaging , Neoplasms, Radiation-Induced/etiology , Osteosarcoma/diagnostic imaging , Osteosarcoma/etiology , Radiography , Radiotherapy/adverse effectsABSTRACT
Malignant fibrous histiocytoma commonly occurs spontaneously. In some cases it follows previous therapeutic or incidental irradiation, or miscellaneous pre-existing osseous conditions. Recently, it has been associated with total hip arthroplasty. We report a case of malignant fibrous histiocytoma following radiation therapy of fibrous dysplasia and review the relevant literature.
Subject(s)
Bone Neoplasms/etiology , Femoral Neoplasms/etiology , Fibrous Dysplasia of Bone/radiotherapy , Histiocytoma, Benign Fibrous/etiology , Neoplasms, Radiation-Induced/etiology , Fibrous Dysplasia of Bone/diagnostic imaging , Humans , Male , Middle Aged , RadiographyABSTRACT
The McCune-Albright syndrome, comprising polyostotic fibrous dysplasia, cutaneous pigmentation and endocrine hyperfunction, is occasionally complicated by acromegaly due to a pituitary adenoma. We report a patient with the McCune-Albright syndrome and acromegaly, who developed secondary hypothyroidism and hypoadrenalism, in whom surgical removal of the pituitary tumour was technically difficult. A combination of a long-acting somatostatin analogue ('Sandostatin') and external irradiation were therefore used as treatment.
Subject(s)
Acromegaly/therapy , Adenoma/complications , Fibrous Dysplasia of Bone/complications , Pituitary Neoplasms/complications , Acromegaly/etiology , Adenoma/drug therapy , Adenoma/radiotherapy , Adult , Combined Modality Therapy , Female , Fibrous Dysplasia of Bone/drug therapy , Fibrous Dysplasia of Bone/radiotherapy , Humans , Octreotide/therapeutic use , Pituitary Neoplasms/drug therapy , Pituitary Neoplasms/radiotherapyABSTRACT
The paper is concerned with the results of follow-up of 21 patients who were given radiation therapy (gamma-beam and x-ray therapy) for fibrous osteodysplasia of the cranial bones over the period of 1946-1973. The summary focal doses varied from 30 to 100 Gy. Radiation injuries came to the foreground (changes in the skin, radiation cataract, necrosis of the maxillary bones and the development of malignant tumors in two cases). Thus the use of radiation therapy in these cases turned out to be not only ineffective but also unsafe.
