251
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Fanton JW, Golden JG. Radiation-induced endometriosis in Macaca mulatta. Radiat Res 1991; 126:141-6. [PMID: 1850850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Female rhesus monkeys received whole-body doses of ionizing radiation in the form of single-energy protons, mixed-energy protons, X rays, and electrons. Endometriosis developed in 53% of the monkeys during a 17-year period after exposure. Incidence rates for endometriosis related to radiation type were: single-energy protons, 54%; mixed-energy protons, 73%; X rays, 71%; and electrons, 57%. The incidence of endometriosis in nonirradiated control monkeys was 26%. Monkeys exposed to single-energy protons, mixed-energy protons, and X rays developed endometriosis at a significantly higher rate than control monkeys (chi 2, P less than 0.05). Severity of endometriosis was staged as massive, moderate, and minimal. The incidence of these stages were 65, 16, and 19%, respectively. Observations of clinical disease included weight loss in 43% of the monkeys, anorexia in 35%, space-occupying masses detected by abdominal palpation in 55%, abnormal ovarian/uterine anatomy on rectal examination in 89%, and radiographic evidence of abdominal masses in 38%. Pathological lesions were endometrial cyst formation in 69% of the monkeys, adhesions of the colon in 66%, urinary bladder in 50%, ovaries in 86%, and ureters in 44%, focal nodules of endometrial tissue throughout the omentum in 59%, and metastasis in 9%. Clinical management of endometriosis consisted of debulking surgery and bilateral salpingo-oophorectomy combined in some cases with total abdominal hysterectomy. Postoperative survival rates at 1 and 5 years for monkeys recovering from surgery were 48 and 36%, respectively.
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252
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Eckert F, Schaich B, Landthaler M. [Spinocellular cancers and myxoid atypical fibroxanthoma of an actinically damaged burn scar]. DER HAUTARZT 1991; 42:254-7. [PMID: 1860801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We report on a 66-year-old male patient suffering from several squamous cell carcinomas and a myxoid atypical fibroxanthoma of the skin. The tumours developed in burn scars that the patient had had for more than 50 years and that had in part undergone actinic elastosis. The role of burn scars in the development of different skin tumours is pointed out. In addition, we discuss the differential diagnosis of the rare myxoid variant of atypical fibroxanthoma.
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MESH Headings
- Aged
- Biomarkers, Tumor/analysis
- Burns/pathology
- Burns/surgery
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Cell Transformation, Neoplastic/pathology
- Cicatrix/pathology
- Cicatrix/surgery
- Facial Neoplasms/pathology
- Facial Neoplasms/surgery
- Fibrosarcoma/pathology
- Fibrosarcoma/surgery
- Humans
- Immunoenzyme Techniques
- Male
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Radiation-Induced/pathology
- Neoplasms, Radiation-Induced/surgery
- Postoperative Complications/pathology
- Postoperative Complications/surgery
- Skin/pathology
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Surgical Flaps
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253
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Dinehart SM, Anthony JL, Pollack SV. Basal cell carcinoma in young patients after irradiation for childhood malignancy. MEDICAL AND PEDIATRIC ONCOLOGY 1991; 19:508-10. [PMID: 1961139 DOI: 10.1002/mpo.2950190612] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Three patients underwent cranial irradiation as part of treatment for childhood malignancy. Two of these patients had acute lymphocytic leukemia and one had an astrocytoma. All had longlasting remissions from their childhood malignancy but 8-15 years later developed a basal cell carcinoma of the scalp within previous radiation portals. The basal cell carcinomas were all treated successfully using Mohs micrographic surgery. Follow-up of patients receiving irradiation for childhood malignancy should include periodic cutaneous examinations of previously irradiated sites.
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254
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Morita S, Sonoyama T, Nishiyama K, Nakagi K, Nomi S, Ohmori Y, Oka T, Fukuda S. [Two cases of rectal carcinoma that developed as a late complication of pelvic radiotherapy]. GAN NO RINSHO. JAPAN JOURNAL OF CANCER CLINICS 1990; 36:2599-604. [PMID: 2176249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Two cases of a pelvic evisceration have been performed, due to an irradiation-induced rectal cancer. Described are the cases of two women who had been treated with irradiation for a cervical cancer following a hysterectomy, one patient being 65 years old and the other 67. After a latent period that lasted for 12 and 24 years, respectively, each had developed a rectal cancer. In each case, case excised specimen showed diffuse fibrosis and a hyaline change, reflecting the effect of radiation on the tumoral tissue. Cases of an irradiation-induced rectal cancer are uncommon, and the symptoms of enterocolitis caused by irradiation are similar to those of a colorectal cancer. The authors therefore suggest careful and long-term follow-up of patients that have received pelvic radiation.
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255
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Lin GC. [Postradiation cancer of oral and maxillofacial regions]. ZHONGHUA ZHONG LIU ZA ZHI [CHINESE JOURNAL OF ONCOLOGY] 1990; 12:301-3. [PMID: 2272268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Twenty-two patients with postradiation cancer of oral and maxillofacial regions treated in our hospital from 1969 to 1985 are reported. Of them, 3 patients had double postradiation cancers. The shortest interval between the two primary cancers was 3 years, the longest was 32 years with a median of 9 years. Of 15 patients treated with 60Co, 9 patients developed cancers and 6 sarcomas. In 4 patients treated with deep X-ray, cancers developed in 3 and sarcoma in one. Three patients were treated with 60Co, deep X-ray and radium implantation, all of them developed cancers. Radiation dose ranged from 3000 to 10,000 cGy but in most of the patients it was 7000-8000 cGy. In 19/22 patients the postradiation cancers were resected, giving 3 and 5 year survival rates of 50% and 23%. Only 1 patient survived for 14 years. Three patients treated by non-operative methods all died within 1-2 years. More aggressive treatments in patients with postradiation cancer are therefore indicated.
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256
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Panje WR, Dobleman TJ. Facial reconstruction for radiation-induced skin cancer. ARCHIVES OF OTOLARYNGOLOGY--HEAD & NECK SURGERY 1990; 116:470-4. [PMID: 2138463 DOI: 10.1001/archotol.1990.01870040092021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Radiation-induced skin cancers can be difficult to diagnose and treat. Typically, a patient who has received orthovoltage radiotherapy for disorders such as acne, eczema, tinea capitis, skin tuberculosis, and skin cancer can expect that aggressive skin cancers and chronic radiodermatitis may develop subsequently. Cryptic facial cancers can lead to metastases and death. Prophylactic widefield excision of previously irradiated facial skin that has been subject to multiple recurrent skin cancers is suggested as a method of deterring future cutaneous malignancy and metastases. The use of tissue expanders and full-thickness skin grafts offers an expedient and successful method of subsequent reconstruction.
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257
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Kellie SJ, Pratt CB, Parham DM, Fleming ID, Meyer WH, Rao BN. Sarcomas (other than Ewing's) of flat bones in children and adolescents. A clinicopathologic study. Cancer 1990; 65:1011-6. [PMID: 2297650 DOI: 10.1002/1097-0142(19900215)65:4<1011::aid-cncr2820650428>3.0.co;2-#] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The clinicopathologic features and response to therapy of 28 patients with non-Ewing's flat bone sarcoma treated at St. Jude Children's Research Hospital, Memphis, Tennessee, over a 25-year period were reviewed. Twenty-two patients had osteosarcoma, four malignant fibrous histiocytoma, one chondrosarcoma, and one fibrosarcoma. Ages at diagnosis ranged from 3 to 24 years (median, 15 years). Primary sites were craniofacial bones in ten patients, pelvis eight, scapula four, ribs two, metatarsal bones two, clavicle one, and vertebra one. All primary tumors were associated with soft tissue extension; none of the patients had metastatic disease at presentation. Six cases represented second malignancies that arose 5 to 16 years after irradiation for an unrelated tumor. Complete excision was possible in ten patients, eight of whom received postoperative chemotherapy. Five of these patients remain free of disease 1.8+ to 13+ years (median, 8.1 years) from diagnosis. Prolonged remissions after adjuvant chemotherapy were achieved in only two of 18 patients after incomplete surgical resection or biopsy. The median survival time in this group was 1 year (range, 0.2-7.7+ years). The remaining 16 patients had progressive local disease, but only two developed concurrent metastases. Thus, complete surgical resection appears to maximize disease-free survival in patients with non-Ewing's flat bone sarcoma. For the large percentage of patients in whom total resection is not possible, because of soft tissue extension and local invasion of bulky tumors, preoperative chemotherapy may increase the likelihood of complete excision and improve long-term survival.
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258
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Domenicucci M, Artico M, Nucci F, Salvati M, Ferrante L. Meningioma following high-dose radiation therapy. Case report and review of the literature. Clin Neurol Neurosurg 1990; 92:349-52. [PMID: 1963827 DOI: 10.1016/0303-8467(90)90063-b] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A case of meningioma induced by high-dose radiation therapy (40 Gy) is reported. The radiation had been given 11 years previously following operation for cerebral astrocytoma. Pertinent cases of benign meningioma occurring after radiation therapy are reviewed and analyzed.
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259
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DeGroot LJ. Clinical review 2: Diagnostic approach and management of patients exposed to irradiation to the thyroid. J Clin Endocrinol Metab 1989; 69:925-8. [PMID: 2793993 DOI: 10.1210/jcem-69-5-925] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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260
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Lobo-Sanahuja F, Fuscaldo C, Ceciliano N, Carranza A, García I. [Thyroid nodules in children. Experience at the National Children Hospital of Costa Rica]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 1989; 46:586-90. [PMID: 2604873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Clinical charts and biopsies of 32 children with thyroid nodules were reviewed at the National Children's Hospital from 1970 to 1988. The classification between benign and malignant types was only possible by surgery and biopsy. Twenty three (72%) were found to be benign forms and nine (28%) were carcinomas (8 papillary and one follicular). Two of the carcinomas had been irradiated previously because of neuroblastoma, as well as one of the benign type who received radiation to the neck and mediastinum because of a Hodgkin's disease. No patients showed alteration in thyroid functional test (T4 and TSH). Twenty two per cent of the carcinomas and 16% of the benign forms presented higher retention in the gammagram test. Seventy eight per cent of the carcinomas and 70% of the benign types showed a normal gammagram test. Surgery in the benign cases included 10 hemithyroidectomy, 7 sub-total thyroidectomy, 3 total thyroidectomy and 3 node resection. Carcinoma cases included 6 patients with total thyroidectomy with ganglionar modified dissection in three patients; 2 hemithyroidectomy and one with sub-total thyroidectomy. Complications included 3 hypoparathyroidisms, one of them permanent, 3 transitory recurrent paresis and only one child died because of pulmonary metastasis. All carcinoma patients were treated with levothyroxine and three of them also received 1131 in order to control ganglionar metastasis. Total survival rate for carcinoma patients was 83% at 90 months. It is concluded that only with surgery it is possible to classify correctly the histological type of children with thyroid nodes. Clinical evaluation and laboratory tests are useless. However, it has not been defined how big the surgery must be.(ABSTRACT TRUNCATED AT 250 WORDS)
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261
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Abstract
Four cases of thyroidectomy for suspected thyroid carcinoma after previous irradiation for Hodgkin's or non-Hodgkin's lymphoma are reviewed. The patients ranged in age from 18 to 33 years at the time of thyroid surgery with an average latency period of 12 years (range, 8-20 years) from radiation therapy to thyroidectomy. All patients had a clinically palpable thyroid nodule, and pathologically showed a pattern of multiple adenomatous nodules with cytologic atypia. The microscopic changes were sufficiently striking to cause the primary pathologist to request consultation to rule out thyroid carcinoma in each case. Fine-needle aspiration was performed in one case and suggested a thyroid neoplasm. The pathologic findings are reviewed and distinction of this lesion from thyroid carcinoma is discussed.
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262
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Mizuno M, Yoshida J, Shimosawa S, Kuchiwaki H. [Intracranial fibrosarcoma fifteen years after radiotherapy in bilateral retinoblastomas: effect of combined chemotherapy with cisplatin and VP-16]. NO SHINKEI GEKA. NEUROLOGICAL SURGERY 1989; 17:653-7. [PMID: 2812266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We report intracranial fibrosarcoma which developed after radiotherapy for bilateral retinoblastomas. A 16-year-old boy was admitted with swelling of his left eyelid as his chief complaint on September 10, 1987. He had a past history of bilateral retinoblastomas at one year of age, which was treated by bilateral ophthalmectomy and postoperative radiotherapy; 50 Gy to right eye and 60 Gy to left eye. Until fifteen years old, he had no trouble except blindness. On admission, a dumb-bell type huge tumor with the destruction of the orbital roof was demonstrated on CT scan and MRI. The tumor was composed of solid orbital tumor and cystic tumor located in the left frontal lobe. On September 18, partial removal of the orbital tumor and evacuation of the intracranial cyst following embolization of the left external carotid artery was performed. The histological diagnosis of the tumor was fibrosarcoma. For the residual tumor, combined radiochemotherapy was carried out. The patient was treated with intravenous administration of 20 mg/m2 of cisplatin and 60 mg/m2 of VP-16 daily for five days and then whole brain radiotherapy of 26 Gy. On March 27, 1988, he obtained a complete remission of the tumor and was discharged without neurological deficit except blindness. In this case, we have presented a radiation-induced secondary tumor after a treatment of bilateral retinoblastomas. Although the tumor was highly proliferative and invasive fibrosarcoma, we could control it well by multimodality treatment including surgery, radiation and chemotherapy. It is noteworthy that combined chemotherapy with cisplatin and VP-16 was effective against this type of tumor.
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263
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Edwards MJ, Hirsch RM, Broadwater JR, Netscher DT, Ames FC. Squamous cell carcinoma arising in previously burned or irradiated skin. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 1989; 124:115-7. [PMID: 2910238 DOI: 10.1001/archsurg.1989.01410010125024] [Citation(s) in RCA: 97] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Squamous cell carcinoma (SCC) arising in previously burned or irradiated skin was reviewed in 66 patients treated between 1944 and 1986. Healing of the initial injury was complicated in 70% of patients. Mean interval from initial injury to diagnosis of SCC was 37 years. The overwhelming majority of patients presented with a chronic intractable ulcer in previously injured skin. The regional relapse rate after surgical excision was very high, 58% of all patients. Predominant patterns of recurrence were in local skin and regional lymph nodes (93% of recurrences). Survival rates at 5, 10, and 20 years were 52%, 34%, and 23%, respectively. Five-year survival rates in previously burned and irradiated patients were not significantly different (53% and 50%, respectively). This review, one of the largest reported series, better defines SCC arising in previously burned or irradiated skin as a locally aggressive disease that is distinct from SCC arising in sunlight-damaged skin. An increased awareness of the significance of chronic ulceration in scar tissue may allow earlier diagnosis. Regional disease control and survival depend on surgical resection of all known disease and may require radical lymph node dissection or amputation.
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264
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Komorowski RA, Deaconson TF, Vetsch R, Cerletty JM, Wilson SD. DNA content in radiation-associated thyroid cancer. Surgery 1988; 104:992-6. [PMID: 3194850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
DNA content has been reported to be of prognostic significance in differentiated thyroid carcinoma. Since malignant tumors with irradiation as an initiator often contain DNA aberrations, the DNA content of well-differentiated thyroid carcinoma in patients with a prior history of low-dose head and neck irradiation was determined and compared with similar nonradiation-associated lesions. The DNA content of thyroid cancers from 53 patients was determined with use of flow cytometry. Sixteen radiation-associated thyroid carcinomas (11 papillary, 3 follicular, and 2 medullary) all were diploid. In a group of 37 nonradiation-associated tumors, 10 were aneuploid (10 of 29 papillary carcinomas and 0 of 2 follicular or 6 medullary carcinomas). This difference in DNA content is significant (p less than 0.02, Fisher's exact test). These findings were unexpected and suggest that if the initiating irradiation causes a DNA aberration, this aberration is not reflected in DNA content as measured by means of flow cytometry.
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265
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Morota N, Nakaoka Y, Shikata J, Matsui A, Saiki S. [Pneumonectomy of lung cancer diagnosed 21 years after irradiation of 6000 rads for hilar lymphadenopathy]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1988; 36:2655-61. [PMID: 3235870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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266
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Razack MS, Shimaoka K, Sako K, Rao U. Suppressive therapy of thyroid nodules in patients with previous radiotherapy to the head and neck. Am J Surg 1988; 156:290-3. [PMID: 3177753 DOI: 10.1016/s0002-9610(88)80294-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This is a prospective, randomized study of 431 patients with palpable thyroid nodules who had previous radiotherapy for benign disorders of the head and neck area to determine the response of the thyroid nodules to suppressive therapy and the incidence of thyroid cancer in patients who could not be suppressed and had surgery. A complete response was achieved within 6 months in 18.3 percent of the patients, and in an additional 26 percent of patients between 7 and 12 months postoperatively. Twenty percent of the patients showed complete disappearance of nodules after 1 to 2 years of suppressive therapy. Twenty-two percent who underwent surgery showed carcinoma. If suppressive therapy is to be used, a trial of 1 year rather than 3 or 6 months, as often recommended, may be appropriate.
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267
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268
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Squire R, Bianchi A, Jakate SM. Radiation-induced sarcoma of the breast in a female adolescent. Case report with histologic and therapeutic considerations. Cancer 1988; 61:2444-7. [PMID: 3365667 DOI: 10.1002/1097-0142(19880615)61:12<2444::aid-cncr2820611209>3.0.co;2-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A 14-year-old girl developed a radiation-induced sarcoma of the left breast after successful combined surgical and radiation therapy of a left adrenal carcinoma when she was 9 months old. The breast lesion was histologically described as a stromal sarcoma with fibrosarcomatous and myxosarcomatous areas. The second primary lesion and local recurrence of this was treated with surgery. At each recurrence the tumor became more aggressive both clinically and histologically, and eventually proved fatal.
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269
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Miholic J, Schwarz C, Moeschl P. Surgical therapy of radiation-induced lesions of the colon and rectum. Am J Surg 1988; 155:761-4. [PMID: 3377116 DOI: 10.1016/s0002-9610(88)80038-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Thirty-six operations for late sequelae of radiotherapy were carried out in 31 patients from 1971 to 1986. The most frequent indications for surgery were stricture (58 percent) and fistula (29 percent). In the first 8 year period from 1971 through 1978, 13 of 14 operations were diversions (colostomy or by-pass). From 1979 through 1986, a more aggressive approach prevailed. Only 32 percent of the operations were diversions. This more aggressive strategy was accompanied by a decrease of the postoperative mortality rate from 21 percent through 1978 to 0 in the later period. The overall complication rate was 23 percent. Complications were relatively more frequent after two-layer sutured or stapled anastomoses and after resection or fistula closure without temporary colostomy. We conclude that in radiation-induced colonic and rectal lesions, diversion should be performed in patients with unproved cure of disease or tumor persistence. Resection and fistula closure can be carried out safely, and a temporary colostomy is strongly recommended.
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270
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Dierssen G, Alvarez G, Figols J. Anaplastic astrocytomas associated with previous radiotherapy: report of three cases. Neurosurgery 1988; 22:1095-7. [PMID: 3419575 DOI: 10.1227/00006123-198806010-00024] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In a group of 132 patients with malignant astrocytomas treated between 1971 and 1983, there were 3 patients who had received radiotherapy to the head several years before developing the glioma. The cases are described, and the evidence supporting the view that the gliomas might be radiation-induced is discussed.
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271
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Talmi Y, Kalmanovitch M, Zohar Y. Thyroid carcinoma, cataract and hearing loss in a patient after irradiation for facial hemangioma. J Laryngol Otol 1988; 102:91-2. [PMID: 3343574 DOI: 10.1017/s0022215100104086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Thyroid carcinoma and cataract are well established complications of irradiation treatment to the head and neck region. Hearing loss is also a documented complication though less frequently reported. A rare case of a patient suffering from all three complications due to irradiation of the face by 24,000 rads for a hemangioma is reported. The pertinent literature is reviewed.
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272
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Balasubramaniam C, Armstrong D, Cheek W, Laurent J. Postradiation meningioma in a child. PEDIATRIC NEUROSCIENCE 1988; 14:319-23. [PMID: 3270054 DOI: 10.1159/000120412] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Tumors caused by radiation treatment are not unknown. They may be benign or malignant. Among these, postradiation meningiomas (PRM) are considered to be a distinct entity. A case of a child who developed a PRM is presented. She received radiation therapy for a presumed thalamic glioma 11 years earlier. An unusual and interesting aspect of this tumor was its attachment to the membrane of the old subdural hematoma, following a shunting procedure. There was no dural attachment. The pathology of PRMs and meningiomas in children are discussed in light of our recent experience.
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273
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Evans HB, Lampe HB. The radial forearm flap in head and neck reconstruction. THE JOURNAL OF OTOLARYNGOLOGY 1987; 16:382-6. [PMID: 3694747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The radial forearm flap has proven to be a very reliable and versatile technique for reconstructing head and neck defects. It is of particular value where segmental defects in the mandible and intraoral mucosa exist, and in reconstructing defects within radiated tissue. The skin of the flap drapes well over the radial bone to allow denture fitting. The radial bone provides an adequate bony strut to allow essentially normal mandibular function. In a previously radiated bed, the flap (from a non-irradiated area) has the virtue of being highly vascular, thus benefiting wound healing. The lack of bulk in the flap prevents separation at the site of inset as wound healing occurs. It is a one-stage reconstruction, and since the donor site is on the upper extremity, early patient mobilization is possible. The donor defect is cosmetically acceptable, and since it lies against the body in the position of rest, it is not frequently exposed. The osseous portion of the flap in a postmenopausal woman should be approached with caution and patients should be warned of the risk of radius fracture. This flap is capable of providing tissue for reconstruction of the head and neck and should be considered for closure of all major defects, particularly those with bone defects or in defects created postirradiation.
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274
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Ushio Y, Arita N, Yoshimine T, Nagatani M, Mogami H. Glioblastoma after radiotherapy for craniopharyngioma: case report. Neurosurgery 1987; 21:33-8. [PMID: 3614601 DOI: 10.1227/00006123-198707000-00007] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A 6-year-old girl developed a glioblastoma in the basal ganglia and brain stem 5 years after surgical excision and local irradiation (5460 cGy) for craniopharyngioma. Clinical and histological details are presented, and the literature on radiation-induced gliomas is reviewed.
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275
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McHenry C, Jarosz H, Calandra D, McCall A, Lawrence AM, Paloyan E. Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 1987; 122:684-6. [PMID: 3579583 DOI: 10.1001/archsurg.1987.01400180066012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The question of thyroid neoplasia following high-dose radiation treatment to the neck and mediastinum for malignant neoplasms such as Hodgkin's lymphoma in children and young adults has been raised recently. Five patients, 19 to 39 years old, were operated on for thyroid neoplasms that developed following cervical and mediastinal radiation therapy for Hodgkin's lymphoma. Three patients had papillary carcinomas and two had follicular adenomas. The latency period between radiation exposure and the diagnosis of thyroid neoplasm ranged from eight to 16 years. This limited series provided strong support for the recommendation that children and young adults who are to receive high-dose radiation therapy to the head, neck, and mediastinum should receive suppressive doses of thyroxine prior to radiation therapy in order to suppress thyrotropin (thyroid-stimulating hormone) and then be maintained on a regimen of suppression permanently.
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