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Satyarth S, Parikh S, Anand A, Sawhney J, Panchal H, Patel A, Shah S. Acute Lymphoblastic Leukemia as Secondary Malignancy in a Case of Ewing's Sarcoma on Treatment. Indian J Med Paediatr Oncol 2017; 38:354-356. [PMID: 29200689 PMCID: PMC5686982 DOI: 10.4103/ijmpo.ijmpo_110_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The survival of Ewing's sarcoma (ES) has improved due to advances in both local and systemic therapy. This has given rise to an increased detection of second malignant neoplasms which can be in the form of solid tumors and hematological malignancies. The most common hematological malignancies are acute myeloid leukemia/myelodysplastic syndrome. Acute lymphoblastic leukemia (ALL) is relatively uncommon in occurrence in this setting. Furthermore, the average refractory period for hematological malignancies varies from 3 to 5 years. We report a case of a young female who developed ALL while on adjuvant therapy for ES.
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Affiliation(s)
- Satyam Satyarth
- Department of Medical Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - Sonia Parikh
- Department of Medical Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - Asha Anand
- Department of Medical Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - Jyoti Sawhney
- Department of Medical Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - Harsha Panchal
- Department of Medical Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - Apurva Patel
- Department of Medical Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - Sandeep Shah
- Department of Medical Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
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Ewing's Sarcoma as a Second Malignancy in Long-Term Survivors of Childhood Hematologic Malignancies. Sarcoma 2016; 2016:5043640. [PMID: 27524931 PMCID: PMC4976151 DOI: 10.1155/2016/5043640] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 06/19/2016] [Indexed: 12/20/2022] Open
Abstract
Modern multimodal treatment has significantly increased survival for patients affected by hematologic malignancies, especially in childhood. Following remission, however, the risk of developing a further malignancy is an important issue. The long-term estimated risk of developing a sarcoma as a secondary malignancy is increased severalfold in comparison to the general population. Ewing's sarcoma family encompasses a group of highly aggressive, undifferentiated, intra- and extraosseous, mesenchymal tumors, caused by several types of translocations usually involving the EWSR1 gene. Translocation associated sarcomas, such as Ewing sarcoma, are only rarely encountered as therapy associated secondary tumors. We describe the clinical course and management of three patients from a single institution with Ewing's sarcoma that followed successfully treated lymphoblastic T-cell leukemia or non-Hodgkin lymphoma. The literature on secondary Ewing's sarcoma is summarized and possible pathogenic mechanisms are critically discussed.
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Lim SH, Lee JY, Lee JY, Kim JH, Choi KH, Hyun JY, Ko YH, Lee J, Kim SJ, Kim WS. Unusual presentation of Ewing sarcoma in the adrenal gland: a secondary malignancy from a survivor of Burkitt lymphoma. Jpn J Clin Oncol 2013; 43:676-80. [PMID: 23564674 DOI: 10.1093/jjco/hyt047] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The occurrence of Ewing sarcoma as a secondary malignancy is an extremely rare event in long-term cancer survivors. In addition, the occurrence of Ewing sarcoma in the adrenal gland is highly unusual. In this case report, we treated a 20-year-old male patient with cyclophosphamide, doxorubicin, vincristine, dexamethasone, and methotrexate and cytarabine chemotherapy following a diagnosis of Stage IV Burkitt lymphoma. Following complete remission, he had been maintained for 2 years without evidence of disease. However, a regular follow-up computed tomography scan found a left adrenal gland mass and a biopsy revealed positive membrane-localized mic-2 expression (CD99) and the presence of the translocation of the EWSR1 gene. To our knowledge, this is the first case report of Ewing sarcoma occurring in the adrenal gland of a patient who was treated with cyclophosphamide, doxorubicin, vincristine, dexamethasone/methotrexate and cytarabine chemotherapy for Burkitt lymphoma.
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Affiliation(s)
- Sung Hee Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710, Korea
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Applebaum MA, Goldsby R, Neuhaus J, DuBois SG. Clinical features and outcomes in patients with secondary Ewing sarcoma. Pediatr Blood Cancer 2013; 60:611-5. [PMID: 22847990 PMCID: PMC3488141 DOI: 10.1002/pbc.24251] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 06/13/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Ewing sarcoma (EWS) is rarely diagnosed as a second malignancy. We sought to describe a cohort of patients with secondary EWS and investigate if patient characteristics and survival differ between patients with secondary and primary EWS. PROCEDURE Patients with EWS or peripheral primitive neuroectodermal tumor (PNET) reported to the Surveillance, Epidemiology, and End Results Program (SEER) database from 1973 to 2008 were evaluated based on primary or secondary tumor sequence. Overall survival was estimated by Kaplan-Meier methods and evaluated using the log-rank test. Competing risk analysis was used to describe risk of death due to malignancy rather than other causes. RESULTS Fifty-eight cases of secondary EWS were reported, accounting for 2.1% of all EWS cases. The median latency from primary malignancy to secondary EWS was 64 months (range 1-282 months). 12.1% of patients with secondary EWS received radiation to the site of secondary tumor during therapy for their primary malignancy. Patients with secondary EWS were more likely to have axial tumors (77.4% vs. 62.5%; P = 0.03) and smaller tumors (75.0% vs. 48.2% <8 cm; P = 0.001). Five-year overall survival from diagnosis was inferior for patients with secondary compared to primary EWS (34.3% vs. 52.2%; P = 0.002). However, patients with secondary tumors were less likely than those with primary EWS to die from their malignancy [hazard ratio 0.44; 95% confidence interval (CI) 0.23-0.85]. CONCLUSIONS Secondary EWS accounts for a minority of cases of EWS. Tumor size and site and patient survival differ among patients with primary and secondary EWS.
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Affiliation(s)
- Mark A. Applebaum
- Department of Pediatrics, University of California, San Francisco School of Medicine, San Francisco, California
| | - Robert Goldsby
- Department of Pediatrics, University of California, San Francisco School of Medicine, San Francisco, California
| | - John Neuhaus
- Department of Biostatistics, University of California, San Francisco School of Medicine, San Francisco, California
| | - Steven G. DuBois
- Department of Pediatrics, University of California, San Francisco School of Medicine, San Francisco, California
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Tahasildar N, Goni V, Bhagwat K, Tripathy SK, Panda BB. Ewing's sarcoma as second malignancy following a short latency in unilateral retinoblastoma. J Orthop Traumatol 2011; 12:167-71. [PMID: 21826516 PMCID: PMC3163792 DOI: 10.1007/s10195-011-0152-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 07/04/2011] [Indexed: 02/05/2023] Open
Abstract
Second malignancies, mostly in the form of bone sarcomas, are known to occur in hereditary retinoblastomas, which usually present with bilateral disease. Only 2 cases of Ewing's sarcoma have been reported in the literature following sporadic unilateral retinoblastoma. A 5-year-old boy presented to our hospital with Ewing's sarcoma of the right humerus (proven by biopsy and immunohistochemistry) following successful treatment of retinoblastoma of the left eye with enucleation and chemotherapy 2 years previously. He was treated with 2 cycles of chemotherapy followed by radiation therapy. At 15 months follow-up, the tumor had reduced in size and the child had a good functional outcome. The cumulative risk of second malignancies in retinoblastoma survivors is 32%. Ninety-eight percent of second malignancies occur in patients with bilateral retinoblastoma. Germ line mutations have been considered in sporadic tumors occurring bilaterally and multifocal unilateral sporadic tumors. Bone and soft tissue sarcomas are the most common second malignancies. Radiation therapy increases the risk of developing a second malignancy in the irradiated field. Unilateral retinoblastomas, which comprise the majority of retinoblastomas, are not immune from the development of second malignancies. Close follow-up of all retinoblastomas--even in the early period--can improve the outcome by facilitating the early detection and aggressive treatment of second malignancies.
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Affiliation(s)
- Naveen Tahasildar
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India.
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Jones KB, Schiffman JD, Kohlmann W, Randall RL, Lessnick SL, Cannon-Albright LA. Complex genotype sarcomas display familial inheritance independent of known cancer predisposition syndromes. Cancer Epidemiol Biomarkers Prev 2011; 20:751-7. [PMID: 21242332 DOI: 10.1158/1055-9965.epi-10-1174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The low incidence of sarcomas in the general population makes heritable contribution to disease risk difficult to discern beyond highly penetrant Mendelian syndromes. METHODS The Utah Cancer Registry (UCR) and Utah Population Database were interrogated for sarcoma diagnostic codes grouped by genetic type, either complex genotype/karyotype sarcoma or balanced translocation-associated sarcoma. The genealogic index of familiality (GIF) was calculated and relative risks (RR) of disease estimated for first-, second-, and third-degree relatives of sarcoma probands. Cancer patterns in pedigrees of sarcoma probands were examined to rule out known hereditary cancer syndromes. RESULTS A total of 229 balanced translocation type and 1,161 complex genotype type sarcomas with at least three generations of ancestral genealogy data were identified in the UCR. There was no evidence for excess relatedness for the balanced translocation group by using the GIF test (P = 0.657) and no significantly elevated RRs. In the complex genotype group, we observed significantly elevated GIF (P = 0.03). Modest RRs corroborated the GIF analysis, in which excess relatedness existed in distant relationships. No recognized cancer syndromes were identified among high-risk pedigrees. DISCUSSION We identified strong familiality among complex genotype sarcomas, independent from known cancer predisposition syndromes. In the absence of significantly elevated RRs for close relatives, the high GIF argues for a strong genetic-rather than environmental-component to complex genotype sarcoma risk. We observed no significant familial risk of developing balanced translocation-associated sarcomas, but the sample was small. IMPACT There exists yet to be deciphered heritable risk for developing complex genotype sarcomas.
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Affiliation(s)
- Kevin B Jones
- Sarcoma Services, Department of Orthopaedics, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA.
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Abstract
Ewing's sarcoma (ES) is a rare tumor that is most common in children and young adults. Late effects of ES therapy include second cancers, a tragic outcome for survivors of such a young age. This paper will explore the frequencies and types of malignancies that occur after ES. Additionally, it will review how second malignancies have changed with the shift in treatment from high-dose radiation to chemotherapy regimens including alkylators and epipodophyllotoxins. The risk of additional cancers in ES survivors will also be compared to survivors of other childhood cancers. Finally, the possible genetic contribution to ES and second malignancies will be discussed.
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Randall RL, Lessnick SL, Jones KB, Gouw LG, Cummings JE, Cannon-Albright L, Schiffman JD. Is There a Predisposition Gene for Ewing's Sarcoma? JOURNAL OF ONCOLOGY 2010; 2010:397632. [PMID: 20300555 PMCID: PMC2838402 DOI: 10.1155/2010/397632] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 12/14/2009] [Accepted: 02/08/2010] [Indexed: 11/18/2022]
Abstract
Ewing's sarcoma is a highly malignant tumor of children and young adults. The molecular mechanisms that underlie Ewing's Sarcoma development are beginning to be understood. For example, most cases of this disease harbor somatic chromosomal translocations that fuse the EWSR1 gene on chromosome 22 with members of the ETS family. While some cooperative genetic events have been identified, such as mutations in TP53 or deletions of the CDKN2A locus, these appear to be absent in the vast majority of cases. It is therefore uncertain whether EWS/ETS translocations are the only consistently present alteration in this tumor, or whether there are other recurrent abnormalities yet to be discovered. One method to discover such mutations is to identify familial cases of Ewing's sarcoma and to then map the susceptibility locus using traditional genetic mapping techniques. Although cases of sibling pairs with Ewing's sarcoma exist, familial cases of Ewing's sarcoma have not been reported. While Ewing's sarcoma has been reported as a 2nd malignancy after retinoblastoma, significant associations of Ewing's sarcoma with classic tumor susceptibility syndromes have not been identified. We will review the current evidence, or lack thereof, regarding the potential of a heritable condition predisposing to Ewing's sarcoma.
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Affiliation(s)
- R. L. Randall
- Sarcoma Services, Department of Orthopaedics, Huntsman Cancer Institute and Primary, Children's Medical Center, The University of Utah, Utah, UT 84112, USA
| | - S. L. Lessnick
- Department of Oncological Sciences, Division of Pediatric Hematology/Oncology, Center for Children's Cancer Research, Huntsman Cancer Institute, The University of Utah, Utah, UT 84112, USA
| | - K. B. Jones
- Sarcoma Services, Department of Orthopaedics, Huntsman Cancer Institute and Primary, Children's Medical Center, The University of Utah, Utah, UT 84112, USA
| | - L. G. Gouw
- Division of Medical Oncology, The University of Utah, Utah, UT 84112, USA
| | - J. E. Cummings
- Department of Orthopaedics, Indiana University, Indiana, IN 46202, USA
| | - L. Cannon-Albright
- Division of Genetic Epidemiology, Department of Internal Medicine, The University of Utah, Utah, UT 84112, USA
- George E. Wallen Department, Veterans Affairs Medical Center, Salt Lake City, The University of Utah, Utah, UT 84148, USA
| | - J. D. Schiffman
- Department of Oncological Sciences, Division of Pediatric Hematology/Oncology, Center for Children's Cancer Research, Huntsman Cancer Institute, The University of Utah, Utah, UT 84112, USA
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Mittal R, Al Awadi S, Sahar O, Behbehani AM. Ewing's sarcoma as second malignant neoplasm after retinoblastoma: a case report. Med Princ Pract 2008; 17:84-5. [PMID: 18059108 DOI: 10.1159/000109597] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2007] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To report a case of a child with the hereditary form of unilateral retinoblastoma (RB), who developed Ewing's sarcoma of the right fibula 3 years after the enucleation of the right eye. CASE PRESENTATION AND INTERVENTION The child was diagnosed as a case of RB of the right eye at the age of 9 months. He was fully investigated and found to have locally advanced RB with bone marrow involvement (Reese-Ellsworth stage IVA). Enucleation was recommended to the family, but they refused. The patient received chemotherapy and diode laser thermotherapy in Kuwait and the UK. He had a local relapse after 11 months and subsequently underwent enucleation of the right eye. After 3 years, he was investigated for a small swelling in his right lower leg. After extensive investigations, it was reported as Ewing's sarcoma. He was treated with chemotherapy, surgery (complete excision of the fibula) and high-dose chemotherapy followed by autologous stem cell transplantation. The child is now nearly 2 years after completing the treatment and is disease free. CONCLUSIONS This case confirms the increased risk of a second malignant neoplasm (SMN) in children with hereditary RB. These children need a very close follow-up for the early diagnosis of SMNs or even subsequent malignancies.
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Affiliation(s)
- Rakesh Mittal
- Department of Medical Oncology, Hussain Maki Al Juma Centre for Specialized Surgeries, Kuwait.
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Spunt SL, Rodriguez-Galindo C, Fuller CE, Harper J, Krasin MJ, Billups CA, Khoury JD. Ewing sarcoma-family tumors that arise after treatment of primary childhood cancer. Cancer 2006; 107:201-6. [PMID: 16721801 DOI: 10.1002/cncr.21962] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Unlike osteosarcoma, the Ewing sarcoma family of tumors (ESFT) has rarely been reported as secondary malignant neoplasms after treatment of childhood cancer. ESFT arising as a second cancer was reviewed and characterized at our childhood cancer center. METHODS A retrospective review was undertaken of 11,183 patients age <21 years who were treated for a primary cancer between March 1962 and December 2003 at St. Jude Children's Research Hospital. All cases of ESFT were confirmed to have a rearranged EWS gene. RESULTS Six cases of ESFT (1.3% of 479 second cancers) were identified in patients previously treated for lymphoma (n = 3), leukemia (n = 1), retinoblastoma (n = 1), or Wilms tumor (n = 1). None of these patients had a family history suggestive of a familial cancer syndrome. The median time between diagnosis of primary cancer and diagnosis of ESFT was 5.9 years (range, 3.1-18.3 years). ESFT occurred in typical anatomic locations: rib (n = 2), chest wall soft tissues (n = 2), pelvis (n = 1), and extremity (n = 1). One tumor arose at the margin of a previous radiotherapy field and 1 arose distant from previous radiotherapy fields; all other patients had not received radiotherapy. Three patients are alive at the time of this report, including 2 whose ESFT was diagnosed more than 8 years ago. CONCLUSIONS ESFT occurs rarely after treatment of a primary cancer during childhood, and most cases do not appear to be related to radiation therapy. Long-term survival can be achieved in some patients, and therefore secondary ESFT should be treated with curative intent.
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Affiliation(s)
- Sheri L Spunt
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
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Cope JU, Tsokos M, Miller RW. Ewing sarcoma and sinonasal neuroectodermal tumors as second malignant tumors after retinoblastoma and other neoplasms. MEDICAL AND PEDIATRIC ONCOLOGY 2001; 36:290-4. [PMID: 11452937 DOI: 10.1002/1096-911x(20010201)36:2<290::aid-mpo1067>3.0.co;2-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Excesses of various childhood cancers have been reported after retinoblastoma, including a trickle of Ewing sarcoma (ES) and perhaps histologically similar olfactory neuroblastoma, both of which are neural tumors. To update and advance this information, case reports were sought by an extensive review of the literature. PROCEDURE The search was made through the use of PubMed, and the Web of Science (Citation Index Expanded), keying on primary references. Three sinonasal cancers diagnosed as ES were immunohistochemically stained for MIC-2 protein (positive in ES). RESULTS Retinoblastoma occurred before ES in ten cases (seven bilateral). In four others, retinoblastoma (three bilateral) developed before sinonasal neural tumors (poorly differentiated). ES also occurred after 14 cancers other than retinoblastoma (five lymphomas, four leukemias, and one each of five miscellaneous cancers). The predominance of retinoblastoma prior to ES differs markedly from the low-frequency of retinoblastoma among childhood cancers in the general population. On the contrary, cancers other than retinoblastoma were proportionate to those in the general population. Previously, retinoblastoma followed by excesses of osteosarcoma and soft tissue sarcomas has been attributed to the action of the inherited RB-1 gene. The sinonasal tumors stained negative for MIC-2 protein. CONCLUSIONS Heritable retinoblastoma may predispose to ES and perhaps to a subset of poorly differentiated neuroectodermal tumors in the sinonasal region that may be related to olfactory neuroblastoma.
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Affiliation(s)
- J U Cope
- Genetic Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20892-7362, USA.
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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 GENETICS AND CYTOGENETICS 2000; 116:89-96. [PMID: 10640139 DOI: 10.1016/s0165-4608(99)00105-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Ionizing radiation is a well-known risk factor for sarcoma development. To investigate whether radiation-associated sarcomas are characterized by chromosome aberrations that distinguish them from de novo sarcomas, we identified those patients in our series of more than 500 cytogenetically abnormal sarcomas that fulfilled the following criteria: (1) each patient should have been irradiated for another malignancy at least 3 years prior to the sarcoma diagnosis, and (2) the sarcoma should have developed within the field of radiation. Ten patients fulfilling these criteria could be retrieved (median age at sarcoma diagnosis was 55 years, range 17-79; median latency period between primary tumor and radiation-associated sarcoma was 9 years, range 4-30). The diagnoses were typical for radiation-associated sarcomas: 2 each of malignant fibrous histiocytoma, leiomyosarcoma, and pleomorphic sarcoma, and 1 each of osteosarcoma, fibrosarcoma, myxofibrosarcoma, and spindle cell sarcoma. All 10 cases had relatively complex karyotypes with multiple, mostly unbalanced, structural rearrangements, similar to what has been reported in de novo sarcomas of the corresponding histologic subtypes. The only cytogenetic features that were unusually frequent among the radiation-associated sarcomas were the finding of unrelated clones in 3 cases, and loss of material from chromosome arm 3p, in particular 3p21-3pter, in 8 cases. Loss of the same chromosome segment has been described in 4 of the 8 previously published cases of radiation-associated sarcomas that have been analyzed after short-term culturing, which makes this imbalance significantly (P < 0.001) more frequent among radiation-associated sarcomas (12 of 18 cases) than among unselected cases of the corresponding histologic subtypes (74 of 282 cases). In contrast to the cytogenetic results, no 3p deletions were detected among the 6 cases of the present series that could be analyzed by comparative genomic hybridization (CGH). The most frequent imbalance detected by CGH was gain of 15cen-q15 (3 cases), followed by loss of chromosome 13 and gain of 5p, and 7cen-q22, each detected in 2 cases.
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MESH Headings
- Adolescent
- Adult
- Aged
- Chromosome Aberrations/genetics
- Chromosome Disorders
- Chromosomes, Human, Pair 1/genetics
- Chromosomes, Human, Pair 1/radiation effects
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 3/radiation effects
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Male
- Middle Aged
- Neoplasms, Radiation-Induced/genetics
- Nucleic Acid Hybridization
- Sarcoma/genetics
- X Chromosome/genetics
- X Chromosome/radiation effects
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Affiliation(s)
- F Mertens
- Department of Clinical Genetics, University Hospital, Lund, Sweden
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Aparicio J, Segura A, Montalar J, Verdeguer A, Castel V, Sánchez-Heras AB. "Secondary cancers after Ewing sarcoma and Ewing sarcoma as second malignant neoplasm". MEDICAL AND PEDIATRIC ONCOLOGY 1998; 30:259-60. [PMID: 9473762 DOI: 10.1002/(sici)1096-911x(199804)30:4<259::aid-mpo9>3.0.co;2-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Maes P, Brichard B, Vermylen C, Cornu G, Ninane J. Primary and secondary osteosarcoma of the face: a rare childhood malignancy. MEDICAL AND PEDIATRIC ONCOLOGY 1998; 30:170-4. [PMID: 9434826 DOI: 10.1002/(sici)1096-911x(199803)30:3<170::aid-mpo8>3.0.co;2-e] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Osteosarcoma of the head and neck, especially primary forms, remains a rare and highly malignant tumor. PATIENTS This report describes two patients who developed an osteosarcoma of the face more than ten years after treatment for bilateral retinoblastoma. We also report a third patient who presented with a primary osteosarcoma of the right superior maxilla which is one of the rarest tumors encountered in childhood oncology. CONCLUSIONS The mainstay of therapy is surgical resection with negative margins. Careful, long-term follow-up of survivors of hereditary retinoblastoma is essential, especially for those given radiation therapy.
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Affiliation(s)
- P Maes
- Department of Pediatric Hematology and Oncology, Cliniques Universitaires Saint-Luc, Catholic University of Brussels, Belgium
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15
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Oda D, Bavisotto LM, Schmidt RA, McNutt M, Bruckner JD, Conrad EU, Weymuller EA. Head and neck osteosarcoma at the University of Washington. Head Neck 1997; 19:513-23. [PMID: 9278760 DOI: 10.1002/(sici)1097-0347(199709)19:6<513::aid-hed9>3.0.co;2-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Head and neck osteosarcoma is a comparatively rare and aggressive malignancy. Our goal was to examine the experience of head and neck osteosarcoma patients seen over a 15-year period at the University of Washington Medical Center and compare this with the published experience of other centers in terms of demographics, histology, treatment, and survival rate. METHODS We reviewed surgical pathology slides and clinical treatment records of 13 patients who were treated at the University of Washington Medical Center between 1981 and 1996. A total of 17 cases from 13 patients (13 primary tumors and 4 recurrences) were studied. RESULTS There was a slight male predominance, with a male:female ratio of 1.6:1, and median age at diagnosis of 40.9 years (range 22 to 75 years), both slightly higher than has been generally reported. Three of 13 patients had recognized risk factors for the development of osteosarcoma: 2 with a history of prior radiotherapy and 1 with Paget's disease. All surgical pathology specimens were examined independently by two pathologists for histologic grading and typing. At initial presentation, 9/13 (69%) cases had conventional (osteoblastic) histology; 2/13 (15%) were fibroblastic, 1 chondroblastic (8%) and 1 parosteal (8%). Eight of 13 (62%) cases were high grade at initial presentation. Four of 13 (30%) of the primary tumors were low grade 2, of which did not recur over a median follow-up period of 24 months. The other 2 low-grade tumors later recurred locally, as high-grade osteosarcomas, after disease-free intervals of 1 year and 14 years, respectively. One patient had an intermediate-grade tumor which has not recurred as of last follow-up. Combined-modality treatment, including surgery with or without radiotherapy and/or chemotherapy, was given depending on the histologic grade, surgical margins, and recurrence. Some patients with low-grade tumors had surgery only. There were 5 local recurrences, 1 of these following a disease-free interval of 14 years. One patient had 3 separate recurrences at the same site. Ten of 13 (77%) are alive and disease-free. Of the 3 deaths, 1 was related to radiation-induced brain necrosis, without evidence of recurrent tumor. The project 5-year overall survival in this series is 72%, with a mean follow-up of 58 months (median, 36 months). Of those receiving neoadjuvant chemotherapy, 6/7 have survived to the present. CONCLUSION Given the limitations of a small patient population, our data suggest that neoadjuvant chemotherapy may provide benefit in terms of survival. Longer follow-up will be necessary to support this conclusion. Our data also show that our population has a higher-than-average age of onset, low presence of risk factors, and better survival rate in comparison with the published series from other institutions.
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Affiliation(s)
- D Oda
- Department of Oral Biology, School of Dentistry, University of Washington, Seattle 98195, USA
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Abstract
Retinoblastoma, though uncommon, frequently is associated with other second malignant neoplasms, especially bone sarcomas. These second neoplasms can occur in sporadic cases of retinoblastoma, though they more commonly are associated with genetic forms of the disease. This is the first known report of 2 histologically distinct bone sarcomas in a patient with retinoblastoma.
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Affiliation(s)
- R M Kay
- Department of Orthopaedic Surgery, University of California, Los Angeles School of Medicine, 90095-6902, USA
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Smee R. Second malignancies developing after treatment for paediatric cancers. AUSTRALASIAN RADIOLOGY 1995; 39:335-6. [PMID: 8561705 DOI: 10.1111/j.1440-1673.1995.tb00307.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Zoubek A, Simonitsch I, Panzer-Grümayer ER, Ghali D, Pfleiderer C, Haas OA, Mann G, Lang S, Radaszkiewicz T, Gadner H. Ewing tumor after treatment of Ki-1+ anaplastic large cell lymphoma. Therapy-associated secondary neoplasm or unrelated coincidence? CANCER GENETICS AND CYTOGENETICS 1995; 83:5-11. [PMID: 7656205 DOI: 10.1016/s0165-4608(95)00014-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We report on a 20-year-old woman who developed a pelvic small round cell tumor with lung metastases 8 years after diagnosis and successful treatment for Ki-1-positive anaplastic large cell lymphoma (Ki-1+ ALCL) with histiocytic differentiation. Molecular genetic detection of EWS/FLI-1 fusion gene expression in the second tumor by RT-PCR unambiguously confirmed the histopathologic diagnosis of Ewing tumor (ET), whereas no evidence for the presence of this specific gene rearrangement was obtained in a retrospective analysis of the lymphoma tissue. In contrast, expression of a NPM/ALK chimeric gene was observed which was absent in the ET. Moreover, the lymphoma contained a monoallelic D delta 2-D delta 3 T-cell receptor gene rearrangement which was also absent in the ET. Thus, our histopathologic, immunohistochemical, and, in particular, molecular genetic studies support the notion that these tumors were most probably pathogenetically unrelated. Since this is the first report describing such an association between a non-Hodgkin's lymphoma and ET and, since the latter has only rarely been observed as a second malignant neoplasm, it remains a matter of speculation whether in this patient ET developed as a therapy-related secondary neoplasm or independently from the lymphoma as a consequence of either genetic tumor predisposition or mere accidental coincidence.
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MESH Headings
- Base Sequence
- Bone Neoplasms/genetics
- Bone Neoplasms/pathology
- Child
- Female
- Humans
- Immunohistochemistry
- Lung Neoplasms/secondary
- Lymphoma, Large-Cell, Anaplastic/genetics
- Lymphoma, Large-Cell, Anaplastic/pathology
- Lymphoma, Large-Cell, Anaplastic/therapy
- Molecular Sequence Data
- Neoplasms, Second Primary/genetics
- Polymerase Chain Reaction
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/pathology
- Sarcoma, Ewing/secondary
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Affiliation(s)
- A Zoubek
- Children's Cancer Research Institute, St. Anna Children's Hospital, Vienna, Austria
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Busch DB. Radiation and chemotherapy injury: pathophysiology, diagnosis, and treatment. Crit Rev Oncol Hematol 1993; 15:49-89. [PMID: 8240706 DOI: 10.1016/1040-8428(93)90020-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The text in general is not meant to represent the participants' entire presentations. The lecture presenters in general are not responsible for the summaries, and cannot necessarily be assumed to agree with all that is stated, but they deserve credit for providing the lecture and handout material on which the summaries are based, and in most cases have contributed far more to the summaries than I have.
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Affiliation(s)
- D B Busch
- Department of Environmental and Toxicologic Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000
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