Title: Undifferentiated Pleomorphic Sarcoma of Chest Wall –A Rare Case Report

Authors: Dr Karthi P. Kumar, Dr Suma MT

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.94

Abstract

Undifferentiated pleomorphic sarcoma (Malignant fibrous histiocytoma) is a sarcoma that arise from bone or soft tissue. it is the most common type of sarcoma of extremity while MFH of bone is very rare. It occurs most frequently in age group of 45-55 yrs of age. The origin of tumor is not known, and one of the major predisposing factors is radiation. Other Causes include paget’s disease, non-ossifying fibroma and fibrous dysplasia. Post radiation sarcoma accounts for 0.5% to 5.5%.Osteosarcoma, malignant fibrous histiocytoma and fibrosarcoma are the most common .Because adjuvant RT after breast conserving surgery plays a significant role in treatment of early – stage breast cancer, sarcoma of the breast, chest wall, sternum, axilla or supraclavicular region have been reported as a complication of treatment  for breast cancer. We report here a rare case of undifferentiated pleomorphic sarcoma of chest wall in a 51yr old woman who had underwent 6 cycles of chemotherapy and  radiation  following modified radical mastectomy for carcinoma breast

Keywords: Undifferentiated pleomorphic sarcoma, Malignant fibrous histiocytoma (MFH), Radiation therapy (RT).

References

  1. Cahan WG, Woodard HQ, Higinbotham NL, Stewart FW, Coley BL. Sarcoma arising in irradiated bone: report of 11 cases. 1948;1:3–29.
  2. Murray EM, Werner D, Greeff EA, Taylor DA. Postradiation sarcomas: 20 cases and a literature review. Int J RadiatOncolBiol Phys. 1999;45:951–961.
  3. Sheppard DG, Libshitz HI. Post-radiation sarcomas: a review of the clinical and imaging features in 63 cases. Clin Radiol. 2001;56:22–29
  4. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–1232
  5. Yap J, Chuba PJ, Thomas R, Aref A, Lucas D, Severson RK, et al. Sarcoma as a second malignancy after treatment for breast cancer. Int J Radiat Oncol Biol Phys. 2002; 52:1231–1237.
  6. Kirova YM, Vilcoq JR, Asselain B, Sastre-Garau X, Fourquet A. Radiation-induced sarcomas after radiotherapy for breast carcinoma: a large-scale single-institution review. 2005;104:856–863
  7. Erel E, Vlachou E, Athanasiadou M, Hassan S, Chandrasekar CR, Peart F. Management of radiation-induced sarcomas in a tertiary referral centre: a review of 25 cases. 2010;19:424–427
  8. Sheth GR, Cranmer LD, Smith BD, Grasso-Lebeau L, Lang JE. Radiation-induced sarcoma of the breast: a systematic review. 2012;17:405–418.
  9. Acharya S, Sarafoglou K, LaQuaglia M, Lindsley S, Gerald W, Wollner N, et al. Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence. 2003;97:2397–2403
  10. Huang J, Walker R, Groome PG, Shelley W, Mackillop WJ. Risk of thyroid carcinoma in a female population after radiotherapy for breast carcinoma. 2001;92:1411–1418.
  11. Kirova YM, Gambotti L, De Rycke Y, Vilcoq JR, Asselain B, Fourquet A. Risk of second malignancies after adjuvant radiotherapy for breast cancer: a large-scale, single-institution review. Int J Radiat Oncol Biol Phys. 2007;68:359–363.
  12. Rubino C, Shamsaldin A, Lê MG, Labbé M, Guinebretière JM, Chavaudra J, et al. Radiation dose and risk of soft tissue and bone sarcoma after breast cancer treatment Breast Cancer Res Treat. 2005;89:277–288.
  13. Krueger EA, Fraass BA, McShan DL, Marsh R, Pierce LJ. Potential gains for irradiation of chest wall and regional nodes with intensity modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2003;56:1023–1037.
  14. Tabone MD, Terrier P, Pacquement H, Brunat-Mentigny M, Schmitt C, Babin-Boilletot A, et al. Outcome of radiation-related osteosarcoma after treatment of childhood and adolescent cancer: a study of 23 cases. J Clin Oncol. 1999;17:2789–2795.
  15. Jung YS, Na KY, Kim KS, Ahn SH, Lee SJ, Park HK, et al. Nation-wide Korean breast cancer data from 2008 using the breast cancer registration program. J Breast Cancer. 2011;14:229–236

Corresponding Author

Dr Karthi.P. Kumar

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