Imaging findings of radiation-induced sarcoma of the head and neck

doi:10.1259/bjr/20938070

HOME

HELP

FEEDBACK

SUBSCRIPTIONS

Imaging findings of radiation-induced sarcoma of the head and neck

Y Makimoto, MD ¹ S Yamamoto, MD ¹ H Takano, MD ² K Motoori, MD ¹ T Ueda, MD ³ T Kazama, MD ¹ K Kaneoya, MD ¹ R Shimofusa, MD ¹ T Uno, MD ¹ H Ito, MD ¹ T Hanazawa, MD ⁴ Y Okamoto, MD ⁴ and K Hayasaki, MD ⁵

¹ Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba City, Chiba, Japan 260-8670, ² Department of Radiology, Chiba Cancer Center, 666-2 Nitona-chou, Chuou-ku, Chiba City, Chiba, Japan 260-8717, ³ Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan 305-8576, ⁴ Department of Otolaryngology, Chiba University Hospital, 1-8-1 Inohana, Chuou-Ku, Chiba, Japan, ⁵ Department of Head and Neck Surgery, Chiba Cancer Center, Chiba, Japan

View larger version (31K):
[in this window]
[in a new window]

Figure 1. Case 1: 80-year-old woman. (a) Axial CT image showing bone thickening that resulted from radiation therapy (arrow). There was soft tissue growth around the root of the nose bilaterally, and bone destruction was observed (arrowhead). (b) Axial T₁ weighted spin-echo MR image (400/9) showing a low signal intensity tumour. (c) Contrast-enhanced axial T₁ weighted spin-echo MR image (400/20) showing marginal enhancement of the tumour. The tumour showed right orbital invasion.

View larger version (99K):
[in this window]
[in a new window]

Figure 2. Case 2: 66-year-old man. (a) Axial CT image showing the damaged lateral wall of the maxilla and an expansive mass occupying the left maxillary sinus. (b) Coronal CT image showing maxillary bone and temporal bone thickening where they had been exposed to radiation therapy (arrow). (c) Contrast-enhanced axial T₁ weighted spin-echo MR image (300/20) showing heterogeneously enhanced tumour occupying the maxillary sinus. (d) Contrast-enhanced coronal T₁ weighted spin-echo MR image (300/20) showing heterogeneously enhanced tumour with a damaged lateral wall of the maxilla and invasion of the right nasal cavity.

View larger version (80K):
[in this window]
[in a new window]

Figure 3. Case 3: 62-year-old man. (a) Axial CT image showing the right mastoid air cell occupied by the recurrent tumour, which was difficult to detect on CT. Only the part of the tumour invading the posterior fossa can be seen (arrow). Bone destruction in the area of the recurrent tumour is shown in the bone window. (b) Contrast-enhanced axial T₁ weighted spin-echo MR image showing significant enhancement of tumour. The tumour was widely attached to the dura, showing dural enhancement.

View larger version (64K):
[in this window]
[in a new window]

Figure 4. Case 4: 69-year-old woman. (a,b) Axial CT images and contrast-enhanced axial T₁ weighted spin-echo MR image (400/20) showing the sclerosed mandible, a result of radiation therapy. The tumour could be detected with spicula. It showed heterogeneous contrast uptake and formed a soft tissue mass around the mandible extending to the right side.

View larger version (82K):
[in this window]
[in a new window]

Figure 5. Case 5: 59-year-old man. (a) Enhanced CT image showing a damaged left mandible branch and a soft tissue mass mainly in the masticator space. The tumour showed heterogeneous contrast uptake and the posterior wall of the left mandible was also destroyed. (b) Contrast-enhanced axial T₁ weighted spin-echo MR image (500/11) showing heterogeneously enhanced tumour in the left masticator space.

View larger version (134K):
[in this window]
[in a new window]

Figure 6. Case 6: 51-year-old man. Contrast-enhanced CT image showing the recurrent neoplasm destroying the anterior wall of the right mandible and forming a soft tissue mass (arrow).