Prostatic sarcoma after treatment of rectal cancer
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Open Access
Case report
Prostatic sarcoma after treatment of rectal cancer Saleh M Abbas* and Andrew G Hill Address: Department of Surgery, Middlemore Hospital, University of Auckland, New Zealand Email: Saleh M Abbas* - [email protected]; Andrew G Hill - [email protected] * Corresponding author
Published: 30 July 2007 World Journal of Surgical Oncology 2007, 5:82
doi:10.1186/1477-7819-5-82
Received: 14 June 2007 Accepted: 30 July 2007
This article is available from: http://www.wjso.com/content/5/1/82 © 2007 Abbas and Hill; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The relationship between radiation exposure for treatment of cancer and occurrence of a second primary cancer at the irradiated site is well known. This phenomenon is however rare in prostate. Case presentation: A 75-year-old farmer was treated for rectal cancer with preoperative 45 Gy of radiotherapy and abdominoperineal resection. Four years later he developed symptoms of bladder outlet obstruction and acute urinary retention. He underwent a transurethral resection of the prostate. Histological examination of the removed prostate tissue and immunohistochemistry revealed it to be a poorly differentiated sarcoma. Conclusion: We believe this to be the first reported case of radiation-induced sarcoma following radiotherapy treatment for rectal cancer. Since radiotherapy plays a pivotal role in the contemporary treatment of rectal adenocarcinoma, it is relevant to be aware of the potential longterm carcinogenic complications of radiotherapy of the pelvis.
Background Many cancer patients will receive radiation in the course of their cancer treatment [1]. With this increased use of adjuvant radiation, radiation induced cancer has become a well-recognized phenomenon. The relationship between radiation exposure and excess cancer incidence has been well documented for a wide variety of carcinomas and sarcomas in various sites. Soft tissue sarcoma is a well-recognized complication following radiation exposure. The risk is thought to be 1% of patients [2]. Current modalities target tumour precisely but actually increase the overall amount of normal tissue exposed to low to moderate-dose ionising radiation [3]. As increasing numbers of patients with early-stage cancer are treated with radiation and survive longer, it seems
likely that incidence of radiotherapy (RT)-induced soft tissue sarcoma will increase [4]. There is a latency period between radiation and the occurrence of soft tissue sarcoma. The cut-off is thought to be at least four years following radiation treatment. This latency period is necessary to differentiate a RT-induced sarcoma from a second primary that may predate the radiation treatment because no accurate molecular or pathologic markers exist. Thus any
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