Post irradiation osteosarcoma
History of nasopharyngeal carcinoma treated with radiotherapy 10 years ago. Now present with epistaxis, ear pain and discharge.
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Large sclerotic bone lesion at skull base, associated with soft tissue mass.
A post irradiation osteosarcoma may develop when more than 30Gy is given. There is a latency of more than 3 years after RT, on average 11-14 years. It may mimic osteonecrosis and primary recurrence. Imaging feature of osteosarcoma includes bone forming tumor with soft tissue mass and interval growth. Osteonecrosis on the other hand, usually shows osteopenia and heterogeneous bone density with absence of soft tissue mass. It usually develop 1-3 years after RT and no significant change over time.
- Chabchoub I et al., Postirradiation osteosarcoma of the maxilla: a case report and current review of literature. Journal of Oncology, 2009. Mitchell M, Logan PM, Radiation-induced changes in bone, Radiographics 1998;18:1125-36.