Postradiation sarcomas - report of two cases and review of the literature

Induction of secondary sarcomas is a rare late side effect of radiotherapy. We describe two cases of patients diagnosed with sarcomas of the irradiation area a long time after radiotherapy. In the first case the patient, aged 62 years, had a history of radiotherapy due to right breast cancer. After 25 years she was diagnosed with sarcoma of the right lung situated in the irradiated area, metastasising to regional lymph nodes. In the second case the patient. aged 68 years, had a history of radiotherapy due to left breast cancer and endometrial cancer. After 10 years she was diagnosed with advanced sarcoma in the abdominal wall of the suprapubic region and in the left breast. Postradiation sarcomas are late complications of radiotherapy, with different histology and nature. 18F-FDG PET/CT enables accurate staging of postradiation sarcomas, and especially in unclear clinical situations it allows the accurate qualification to optimal treatment.