IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Radiation-associated osteosarcoma

Case contributed by J Yeung
Diagnosis probable

Presentation

History of nasopharyngeal carcinoma treated with radiotherapy 10 years ago. Now present with epistaxis, ear pain and discharge.

Patient Data

Age: Adult
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Large sclerotic bone lesion at skull base, associated with soft tissue mass.

Hypodensity in left temporal lobe is in keeping with post-radiotherapy change.

Case Discussion

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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.