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Published in: Journal of Medical Case Reports 1/2020

Open Access 01-12-2020 | Soft Tissue Tumor | Case report

Tumors associated with radiotherapy: a case series

Authors: Mauricio Garcia, Dary L. Hernandez, Sara Mendoza, Nelson Buelvas, Angelina Alvarez, Jose Esguerra, Sandra Díaz

Published in: Journal of Medical Case Reports | Issue 1/2020

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Abstract

Background

Breast cancer is the cancer with the highest incidence and mortality worldwide. Its treatment is multidisciplinary with surgery, systemic therapy, and radiotherapy. In Colombia, according to Globocan 2018, there is an age-standardized incidence rate of 44 per 100,000 women. Radiotherapy improves local and regional control in patients with breast cancer, and it could even improve relapse-free survival and overall survival in patients with nodal disease. The toxicity of this treatment in most cases is mild and transient, but in a low percentage of patients, radiotherapy-induced tumors may develop.

Case presentation

Seven Colombian patients treated for breast cancer at our institution developed radiotherapy-induced tumors between 2008 and 2018. The median age was 54.4 (range 35–72) years. Six patients had locally advanced tumors at the time breast cancer was diagnosed, and all of them received neoadjuvant or adjuvant chemotherapy and radiotherapy. The radiotherapy-induced tumors were five sarcomas, one of which was a well-differentiated angiosarcomatous vascular lesion with negative c-Myc (benign lesion), and the remaining patient had basal cell carcinoma associated with radiotherapy.

Conclusions

Sarcomas are the most common radiotherapy-induced tumors after breast cancer treatment. These are rare, aggressive tumors and represent between 0.5% and 5.5% of all sarcomas. Basal cell carcinoma has also been associated with breast cancer treatment. The management is individualized and multimodal, including surgical resection and chemotherapy. Different studies have shown that radiation therapy is a risk factor for the development of soft tissue tumors.
Literature
1.
go back to reference Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer 348 Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 349 Cancers in 185 Countries. CA Cancer J Clin. 2018;68(6):394–424.CrossRefPubMed Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer 348 Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 349 Cancers in 185 Countries. CA Cancer J Clin. 2018;68(6):394–424.CrossRefPubMed
3.
go back to reference Murray EM, Werner D, Greeff EA, Taylor DA. Postradiation sarcomas: 20 cases and a literature review. Int J Radiat Oncol Biol Phys. 1999;45(4):951–61.PubMedCrossRef Murray EM, Werner D, Greeff EA, Taylor DA. Postradiation sarcomas: 20 cases and a literature review. Int J Radiat Oncol Biol Phys. 1999;45(4):951–61.PubMedCrossRef
4.
go back to reference Berrington de Gonzalez A, Curtis RE, Gilbert E, Berg CD, Smith SA, Stovall M, et al. Second solid cancers after radiotherapy for breast cancer in SEER cancer registries. Br J Cancer. 2010;102(1):220–6.PubMedCrossRef Berrington de Gonzalez A, Curtis RE, Gilbert E, Berg CD, Smith SA, Stovall M, et al. Second solid cancers after radiotherapy for breast cancer in SEER cancer registries. Br J Cancer. 2010;102(1):220–6.PubMedCrossRef
5.
go back to reference Mery CM, George S, Bertagnolli MM, Raut CP. Secondary sarcomas after radiotherapy for breast cancer: sustained risk and poor survival. Cancer. 2009;115(18):4055–63.PubMedCrossRef Mery CM, George S, Bertagnolli MM, Raut CP. Secondary sarcomas after radiotherapy for breast cancer: sustained risk and poor survival. Cancer. 2009;115(18):4055–63.PubMedCrossRef
6.
go back to reference Uchin JM, Billings SD. Radiotherapy-associated atypical vascular lesions of the breast. J Cutan Pathol. 2009;36(1):87–8.PubMedCrossRef Uchin JM, Billings SD. Radiotherapy-associated atypical vascular lesions of the breast. J Cutan Pathol. 2009;36(1):87–8.PubMedCrossRef
7.
go back to reference Sheth GR, Cranmer LD, Smith BD, Grasso-LeBeau L, Lang JE. Radiation-induced sarcoma of the breast: a systematic review. Oncologist. 2012;17(3):405–18.PubMedPubMedCentralCrossRef Sheth GR, Cranmer LD, Smith BD, Grasso-LeBeau L, Lang JE. Radiation-induced sarcoma of the breast: a systematic review. Oncologist. 2012;17(3):405–18.PubMedPubMedCentralCrossRef
8.
go back to reference Sheppard DG, Libshitz HI. Post-radiation sarcomas: a review of the clinical and imaging features in 63 cases. Clin Radiol. 2001;56(1):22–9.PubMedCrossRef Sheppard DG, Libshitz HI. Post-radiation sarcomas: a review of the clinical and imaging features in 63 cases. Clin Radiol. 2001;56(1):22–9.PubMedCrossRef
9.
go back to reference Sholl LM, Barletta JA, Hornick JL. Radiation-associated neoplasia: clinical, pathological and genomic correlates. Histopathology. 2017;70(1):70–80.PubMedCrossRef Sholl LM, Barletta JA, Hornick JL. Radiation-associated neoplasia: clinical, pathological and genomic correlates. Histopathology. 2017;70(1):70–80.PubMedCrossRef
10.
go back to reference Anzalone CL, Cohen PR, Tschen JA, MacFarlane DF. Radiation-associated atypical vascular lesions: vascular lesions with endothelial cell atypia presenting in the radiation port of breast cancer patients. Skinmed. 2014;12(6):344–8.PubMed Anzalone CL, Cohen PR, Tschen JA, MacFarlane DF. Radiation-associated atypical vascular lesions: vascular lesions with endothelial cell atypia presenting in the radiation port of breast cancer patients. Skinmed. 2014;12(6):344–8.PubMed
11.
go back to reference Zaraa I, Ben Taazayet S, Zribi H, Chelly I, El Euch D, Trojjet S, et al. Cutaneous carcinoma induced by radiotherapy: a report of 31 cases. Tunis Med. 2013;91(3):191–5.PubMed Zaraa I, Ben Taazayet S, Zribi H, Chelly I, El Euch D, Trojjet S, et al. Cutaneous carcinoma induced by radiotherapy: a report of 31 cases. Tunis Med. 2013;91(3):191–5.PubMed
12.
go back to reference Russell WO, Cohen J, Enzinger F, Hajdu SI, Heise H, Martin RG, et al. A clinical and pathological staging system for soft tissue sarcomas. Cancer. 1977;40(4):1562–70.PubMedCrossRef Russell WO, Cohen J, Enzinger F, Hajdu SI, Heise H, Martin RG, et al. A clinical and pathological staging system for soft tissue sarcomas. Cancer. 1977;40(4):1562–70.PubMedCrossRef
13.
go back to reference Laskin WB, Silverman TA, Enzinger FM. Postradiation soft tissue sarcomas: an analysis of 53 cases. Cancer. 1988;62(11):2330–40.PubMedCrossRef Laskin WB, Silverman TA, Enzinger FM. Postradiation soft tissue sarcomas: an analysis of 53 cases. Cancer. 1988;62(11):2330–40.PubMedCrossRef
14.
go back to reference Blanchard DK, Reynolds C, Grant CS, Farley DR, Donohue JH. Radiation-induced breast sarcoma. Am J Surg. 2002;184(4):356–8.PubMedCrossRef Blanchard DK, Reynolds C, Grant CS, Farley DR, Donohue JH. Radiation-induced breast sarcoma. Am J Surg. 2002;184(4):356–8.PubMedCrossRef
15.
go back to reference Taghian A, De Vathaire F, Terrier P, Le M, Auquier A, Mouriesse H, et al. Long-term risk of sarcoma following radiation treatment for breast cancer. Int J Radiat Oncol Biol Phys. 1991;21(2):361–7.PubMedCrossRef Taghian A, De Vathaire F, Terrier P, Le M, Auquier A, Mouriesse H, et al. Long-term risk of sarcoma following radiation treatment for breast cancer. Int J Radiat Oncol Biol Phys. 1991;21(2):361–7.PubMedCrossRef
16.
go back to reference Kirova YM, Vilcoq JR, Asselain B, Sastre-Garau X, Fourquet A. Radiation-induced sarcomas after radiotherapy for breast carcinoma: a large-scale single-institution review. Cancer. 2005;104(4):856–63.PubMedCrossRef Kirova YM, Vilcoq JR, Asselain B, Sastre-Garau X, Fourquet A. Radiation-induced sarcomas after radiotherapy for breast carcinoma: a large-scale single-institution review. Cancer. 2005;104(4):856–63.PubMedCrossRef
17.
go back to reference Salminen SH, Sampo MM, Böhling TO, Tuomikoski L, Tarkkanen M, Blomqvist CP. Radiation-associated sarcoma after breast cancer in a nationwide population: Increasing risk of angiosarcoma. Cancer Med. 2018;7(9):4825–35.PubMedPubMedCentralCrossRef Salminen SH, Sampo MM, Böhling TO, Tuomikoski L, Tarkkanen M, Blomqvist CP. Radiation-associated sarcoma after breast cancer in a nationwide population: Increasing risk of angiosarcoma. Cancer Med. 2018;7(9):4825–35.PubMedPubMedCentralCrossRef
18.
go back to reference Arlen M, Higinbotham NL, Huvos AG, Marcove RC, Miller T, Shah IC. Radiation-induced sarcoma of bone. Cancer. 1971;28(5):1087–99.PubMedCrossRef Arlen M, Higinbotham NL, Huvos AG, Marcove RC, Miller T, Shah IC. Radiation-induced sarcoma of bone. Cancer. 1971;28(5):1087–99.PubMedCrossRef
19.
go back to reference Cha C, Antonescu CR, Quan ML, Maru S, Brennan MF, Aust JB, et al. Long-term results with resection of radiation-induced soft tissue sarcomas. Ann Surg. 2004;239(6):903–9.PubMedPubMedCentralCrossRef Cha C, Antonescu CR, Quan ML, Maru S, Brennan MF, Aust JB, et al. Long-term results with resection of radiation-induced soft tissue sarcomas. Ann Surg. 2004;239(6):903–9.PubMedPubMedCentralCrossRef
20.
go back to reference Dickson MA. Systemic treatment options for radiation-associated sarcomas. Curr Treat Options in Oncol. 2014;15(3):476–81.CrossRef Dickson MA. Systemic treatment options for radiation-associated sarcomas. Curr Treat Options in Oncol. 2014;15(3):476–81.CrossRef
21.
go back to reference Tchanque-Fossuo CN, Eisen DB. A systematic review on the use of cryotherapy versus other treatments for basal cell carcinoma. Dermatol Online J. 2018;24(11):13030/qt49k1c38t.PubMed Tchanque-Fossuo CN, Eisen DB. A systematic review on the use of cryotherapy versus other treatments for basal cell carcinoma. Dermatol Online J. 2018;24(11):13030/qt49k1c38t.PubMed
Metadata
Title
Tumors associated with radiotherapy: a case series
Authors
Mauricio Garcia
Dary L. Hernandez
Sara Mendoza
Nelson Buelvas
Angelina Alvarez
Jose Esguerra
Sandra Díaz
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2020
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-020-02482-x

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