Radiation Induced Osteosarcoma of the Larynx: A Rare Case Report

  • Smrithi Sara Thomas Department of Pathology, MVR Cancer Centre and Research Institute , Vellalasseri NIT,Poolacode, Calicut, India
  • Vijayalakshmi Nair Department of Pathology, MVR Cancer Centre and Research Institute , Vellalasseri NIT,Poolacode, Calicut, India
  • Sajna VM Kutti Department of Pathology, MVR Cancer Centre and Research Institute , Vellalasseri NIT,Poolacode, Calicut, India
  • Vijayagopal KS Department of Radiation Oncology, MVR Cancer Centre and Research Institute, Vellalasseri NIT,Poolacode, Calicut, India
DOI: https://doi.org/10.21276/apalm.3283
Keywords: Radiation induced sarcomas, Osteosarcoma, IHC, Adjuvant chemotherapy

Abstract

Secondary malignancies caused by radiation, especially radiation-induced sarcomas (RIS), are perhaps the most severe late side effects of radiotherapy. The incidence of sarcomas after irradiation is estimated to be as high as 0.3% in those who have survived neck and head cancer for a long time. Nevertheless, it is also accompanied by significant morbidity and mortality. RIS of the head and neck is not prevalent. As there are only a limited number of case reports, we report a case of radiation induced osteosarcoma from our institution.Case report: A 67 year old male patient, previously treated for squamous cell carcinoma larynx with radiotherapy 60 gy, presented to our institution with complaints of hoarseness of voice. CT Neck showed an ill-defined heterogeneously enhancing mass lesion in the larynx with extra laryngeal extension and causing erosion of the thyroid cartilage. He was subsequently taken for total laryngectomy. Histopathological examination showed a high-grade malignant neoplasm. Further IHC revealed tumor cells diffusely positive for SATB2 and negative for PanCK, p63 and p40. He was diagnosed with high grade osteosarcoma and was taken up for adjuvant chemotherapy.Conclusion: As there are only limited case reports, more number of cases should be reported for further discussion about the adjunctive treatment options and prognosis.

References

Kumar S. Second malignant neoplasms following radiotherapy. Int J Environ Res Public Health. 2012;9(12):4744–59.

Singh GK, Yadav V, Singh P, Bhowmik KT. Radiation-Induced Malignancies Making Radiotherapy a “Two-Edged Sword”: A Review of Literature. World J Oncol. 2017;8(1):1–6.

Stone HB, Coleman CN, Anscher MS, McBride WH. Effects of radiation on normal tissue: consequences and mechanisms. Lancet Oncol. 2003;4(9):529–36.

Bennion NR, Baine MJ, Malouff T, Zhen W. Osteosarcoma of the Larynx: Treatment Outcomes and Patterns of Failure Analysis. Rare Tumors. 2017 Mar 24;9(1):6955.

Sheen TS, Wu CT, Hsieh T, Hsu MM. Postirradiation laryngeal osteosarcoma: Case report and literature review. Head Neck. 1997;19(1):57-62.

Frieben H. Demonstration eines Cancroid des rechten Handrueckens, das sich nach langdauernder Einwirkung von Roentgenstrahlen entwickelt hatte. Fortschr Geb Rontgenstr. 1902;6:106–111.

Cahan WG, Woodard HQ, Higinbotham NL, Stewart FW, Coley BL. Sarcoma arising in irradiated bone. Cancer. 1998;82:8–34.

Murray EM, Werner D, Greeff EA, Taylor DA. Postradiation sarcomas: 20 cases and a literature review. Int J Radiat Oncol Biol Phys. 1999;45:951–61.

Morton LM, Onel K, Curtis RE, Hungate EA, Armstrong GT. The rising incidence of second cancers: patterns of occurrence and identification of risk factors for children and adults. Am Soc Clin Oncol Educ Book. 2014;(34):e57–e67.

Laskin WB, Silverman TA, Enzinger FM. Postradiation soft tissue sarcomas. An analysis of 53 cases. Cancer. 1988;62(11):2330-40.

Wei Z, Xie Y, Xu J, Luo Y, Chen F, Yang Y, et al. Radiation-induced sarcoma of head and neck: 50 years of experience at a single institution in an endemic area of nasopharyngeal carcinoma in China. Med Oncol. 2012;29:670–6.

Komdeur R, Hoekstra HJ, Molenaar WM, Van Den Berg E, Zwart N, Pras E, Plaza-Menacho I, Hofstra RM, Van Der Graaf WT. Clinicopathologic assessment of postradiation sarcomas: KIT as a potential treatment target. Clin Cancer Res. 2003;9:2926-2932.

Mertens F, Larramendy M, Gustavsson A, Gisselsson D, Rydholm A, Brosjö O, Mitelman F, Knuutila S, Mandahl N. Radiation-associated sarcomas are characterized by complex karyotypes with frequent rearrangements of chromosome arm 3p. Cancer Genet Cytogenet. 2000;116:89-96.

Myssiorek D, Patel M, Wasserman P, Rofeim O. Osteosarcoma of the larynx. Ann Otol Rhino Laryngol. 1998;107(1):70-4.

Ulusan M, et al. Radiation-induced osteosarcoma of the larynx: case report and literature review. Ear Nose Throat J. 2012 Oct;91(10):408.

Published
05-01-2024
Issue
Vol 11 No 1 (2024)
Section
Case Report

Copyright (c) 2024 Smrithi Sara Thomas, Vijayalakshmi Nair, Sajna VM Kutti, Vijayagopal KS

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).