ABSTRACT
Objective:
To investigate the clinical, imaging, histological, and molecular features and the
differential diagnosis of
radiation-associated
sarcomas of
bone and soft
tissue.
Methods:
Forty-six cases of
radiation-associated
sarcomas of the
bone and soft
tissue in
Beijing Jishuitan
Hospital from January 2010 to January 2022 were retrospectively analyzed; and the imaging, histological features and immunophenotype were examined.
Results:
There were 33
females and 13
males,
aged from 18 to 74 years, with a mean of 52 years. The most common site of
radiation-associated
sarcomas were the
limbs and
spine (15 cases), followed by the
chest (9 cases). The primary
diseases included epithelial
tumors (15
breast cancer, 6
cervical cancer, and 5 bowel
cancer), hematolymphoid
tumors,
bone and soft
tissue tumors and infectious lesions. The latent period of
radiation-associated
sarcomas ranged from 2-22 years, with an average of 11.6 years. Histopathologically, the morphology was divergent from the primary
tumor. The most common malignant
tumor type was undifferentiated
sarcoma (22 cases), followed by
osteosarcoma (16 cases). The immunophenotype of
radiation-related
sarcoma was almost the same as the corresponding
soft tissue sarcoma.
Conclusions:
Radiation-induced
sarcoma has a wide range of primary
tumor types and its imaging, morphology and immunohistochemical features are
similar to those of the primary
sarcoma of
bone and soft
tissue. Clinical correlation is often recommended for the
differential diagnosis.