Imaging findings of radiation-induced sarcoma of the head and neck
Imaging findings of radiation-induced sarcoma of the head and neck
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DOI：
10.1259/bjr/20938070
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发表时间：
2007-10-01
影响因子：
2.6
通讯作者：
Hayasaki, K.
中科院分区：
文献类型：
--
作者：
Makimoto, Y.;Yamamoto, S.;Hayasaki, K.
我们回顾性分析了放射后肉瘤患者的临床和影像学特征，尤其是头颈部。我们回顾了4194例有放射治疗史的头颈部癌患者的记录。他们接受了CT和/或MRI检查。回顾性分析原发性肿瘤的诊断、放射治疗史及潜伏期。患者包括4名男性和2名女性，平均年龄为64.5岁。肉瘤发生的平均潜伏期为11.5年。初步诊断为上颌窦癌、鼻咽癌、口底腺样囊性癌、扁桃体癌、软腭癌和舌癌。组织学检查分别为骨肉瘤、梭形细胞肉瘤、软骨肉瘤、恶性周围神经鞘瘤、梭形细胞癌和恶性纤维组织细胞瘤。常见的表现是不均匀的、强化良好的软组织肿块和骨质破坏。目前有效预防头颈部放射性肉瘤的可能性很小或没有前景。这强调了尽早诊断此类患者的重要性。影像学检查结果不是诊断特异性的，但通过CT和MRI在辐射野内进行严格的随访以及对预期潜伏期的评估可能有助于提供诊断。当头颈部肿瘤接受放射治疗时，可能需要多年的定期随访观察。
We set out to retrospectively review the clinical and imaging features of patients with post-radiation sarcoma, especially in the head and neck region. We reviewed the records of 4194 patients with carcinoma of the head and neck region who had a history of radiation. They had undergone CT and/or MRI. Medical records were reviewed for the primary diagnosis, radiation history and latency period to the development of sarcoma. The patients included four men and two women with a mean age of 64.5 years. The mean latency period for the development of sarcoma was 11.5 years. Primary diagnoses were maxillary carcinoma, nasopharyngeal carcinoma, adenoid cystic carcinoma of the oral floor, tonsilar carcinoma, soft palate carcinoma and tongue carcinoma. Histopathological examinations revealed osteosarcoma, spindle cell sarcoma, chondrosarcoma, malignant peripheral nerve sheath tumour, spindle cell carcinoma and malignant fibrous histiocytoma, respectively. Common findings were a heterogeneous and well-enhanced soft tissue mass and bone destruction. There is at present little or no prospect for the effective prevention of radiation-induced sarcoma of the head and neck. This emphasizes the importance of the earliest possible diagnosis for such patients. The imaging findings are not diagnosis specific, but strict follow-up within the radiation field by CT and MRI and an appreciation of the expected latency period may help to provide the diagnosis. When radiotherapy is performed for head and neck neoplasms, periodic follow-up observations may be necessary for many years.