History of nasopharyngeal carcinoma treated with radiotherapy 10 years ago. Now present with epistaxis, ear pain and discharge.
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
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Large sclerotic bone lesion at skull base, associated with soft tissue mass.
Hypodensity in left temporal lobe is in keeping with post-radiotherapy change.
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.
- 1. Mitchell MJ, Logan PM. Radiation-induced changes in bone. (1998) Radiographics : a review publication of the Radiological Society of North America, Inc. 18 (5): 1125-36; quiz 1242-3. doi:10.1148/radiographics.18.5.9747611 - Pubmed
- 2. Chabchoub I, Gharbi O, Remadi S, Limem S, Trabelsi A, Hochlef M, Ben Fatma L, Landolsi A, Mokni M, Kraiem C, Ben Ahmed S. Postirradiation osteosarcoma of the maxilla: a case report and current review of literature. (2009) Journal of oncology. 2009: 876138. doi:10.1155/2009/876138 - Pubmed