Radiation-associated osteosarcoma

Case contributed by Dr J Yeung


History of nasopharyngeal carcinoma treated with radiotherapy 10 years ago. Now present with epistaxis, ear pain and discharge.

Patient Data

Age: Adult
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Large sclerotic bone lesion at skull base, associated with soft tissue mass.

Hypodensity in left temporal lobe is in keeping with post-radiotherapy change.

Case Discussion

Radiation-associated osteosarcoma may develop when more than 30Gy is given. There is a latency of more than 3 years after radiation therapy, 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 an absence of a soft tissue mass and usually develops 1-3 years after radiation therapy with no significant change over time.

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Case information

rID: 14896
Published: 3rd Sep 2011
Last edited: 19th Jun 2021
Inclusion in quiz mode: Included