Postradiation Sarcoma Clinical Presentation

Updated: Jul 19, 2016
  • Author: Nagarjun Rao, MD, FRCPath; Chief Editor: Harris Gellman, MD  more...
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Presentation

History and Physical Examination

Pain is the most common complaint in patients with postradiation sarcoma (PRS). This pain is abrupt and rapid in onset, relentless and progressive, constant, and worse at night. It usually is not relieved by aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs). Mass (soft tissue or bone), bleeding, and pathologic fracture also are reported. [22, 23] Clinical factors that favor a diagnosis of PRS include the following:

  • Sarcoma in bone or soft tissue appearing at an unusual age
  • Sarcoma in bone or soft tissue at an unusual site
  • Addition of intensive chemotherapy to irradiation

Physical findings are localized to the irradiated area. These usually are a mass (bony or soft tissue), tenderness, and/or a pathologic fracture.

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Complications

PRS is itself a complication of radiation treatment for various bone and soft-tissue malignancies. Complications that arise from PRS are those seen with other soft-tissue and bone tumors, such as pathologic fractures, hemorrhage, metastases, and local complications due to direct invasion.

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