Postradiation Sarcoma (Radiation-Induced Sarcoma) Clinical Presentation

Updated: Jul 06, 2022
  • Author: Nagarjun Rao, MD, FRCPath; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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History and Physical Examination

Pain is the most common complaint in patients with postradiation sarcoma (PRS; also referred to as radiation-induced sarcoma [RIS]). 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.



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.