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Vol. 12. Issue 4.
Pages 348-355 (January 2001)
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Vol. 12. Issue 4.
Pages 348-355 (January 2001)
Sarcoma intracerebral radioinducido
Radiation-induced intracerebral sarcoma
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J.M. Cañizal-García
, A. Bárcena-Orbe, C. Mestre-Moreiro, B. Rivero-Martín, C.A. Rodriguez-Arias
Servicio de Neurocirugía. Hospital Universitario del Aire. Madrid
S. Coca-Menchero*
* Servicio de Anatomía Patológica. Hospital Universitario del Aire. Madrid
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Resumen

Presentamos el caso de un paciente varón de 50 años de edad tratado por un tumor neuroectodérmico primitivo cerebral temporal derecho con extirpación completa y radioterapia postoperatoria que desarrolló un sarcoma intracraneal en el campo de irradiación. El paciente recibió una dosis fraccionada de 50 Gy y una sobreimpre-sión del lecho tumoral llegando a 60 Gy. En la RMN de control 32 meses después de completar la radioterapia y 34 meses después de la cirugía se evidenció una masa en la convexidad temporal derecha. El diagnóstico postoperatorio fue de sarcoma. Dos años después reinterve-nido por una segunda lesión de similares características a la primera. La supervivencia desde el diagnóstico del PNET es de 5 años y 10 meses y la supervivencia del sarcoma desde su diagnóstico es actualmente de 3 años, no existiendo evidencia actual de recidiva.

El desarrollo de un sarcoma secundario a irradiación craneal es un hecho infrecuente pero se debe considerar esta posibilidad en el diagnóstico diferencial cuando una lesión radiada progresa o cuando aparece una nueva lesión varios años después del tratamiento con RT.

Palabras clave:
Carcinogénesis
Tumores radioinducidos
Radioterapia
Sarcoma
Summary

We report a case of radiation-induced sarcoma in a 50 year-old male patient who was treated with total resection and radiation for right temporal lobe PNET. He received a dose of 60-Gy. A sequential magnetic resonance image 32 months after the completion of radiation therapy and 34 months after surgery showed a mass in the right temporal cerebral convexity. The postoperative diagnosis was sarcoma. Two years later the patient was operated because of a new lesion with similar characteristics. The follow up from the PNET diagnosis is 5 years and 10 months and the survival from sarcoma diagnosis is now 3 years and there is no evidence of recurrence.

The development of sarcoma subsequent to cranial irradiation is an infrequent event but it should be considered in the differential diagnosis of a lesion that progresses several years after radiation therapy or when a new lesion appear.

Keywords:
Carcinogenesis
Radiation-induced tumors
Radiation therapy
Sarcoma

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