Radiation-induced osteosarcoma 17 years after mediastinal irradiation following surgical removal of thymoma

Gen Thorac Cardiovasc Surg. 2010 Dec;58(12):651-3. doi: 10.1007/s11748-010-0587-x. Epub 2010 Dec 18.


Radiation-induced osteosarcoma is a rare complication after irradiation of primary malignancies. In the chest wall, it is usually secondary to radiotherapy for breast cancer or lymphoma. We report a rare case of radiation-induced osteosarcoma of the sternum after mediastinal irradiation of a thymoma. A 49-year-old woman presented with a sternal tumor 17 years after surgery plus mediastinal irradiation (50 Gy) for a stage III thymoma. On biopsy, this second tumor was diagnosed as a radiation-induced osteosarcoma. Systemic survey revealed additional metastatic spread to vertebrae and pelvis. Despite intensive combination chemotherapy that initially stabilized her disease, the patient died 2 years after the diagnosis was made. Because thymoma patients receiving mediastinal irradiation are thus at additional risk of radiation-induced secondary malignancy, long-term follow-up is advisable.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / etiology*
  • Bone Neoplasms / pathology
  • Fatal Outcome
  • Female
  • Humans
  • Middle Aged
  • Neoplasms, Radiation-Induced / etiology*
  • Neoplasms, Radiation-Induced / pathology
  • Osteosarcoma / drug therapy
  • Osteosarcoma / etiology*
  • Osteosarcoma / secondary
  • Radiotherapy, Adjuvant / adverse effects
  • Sternum / pathology
  • Sternum / radiation effects*
  • Thymectomy*
  • Thymoma / radiotherapy
  • Thymoma / surgery
  • Thymoma / therapy*
  • Thymus Neoplasms / radiotherapy
  • Thymus Neoplasms / surgery
  • Thymus Neoplasms / therapy*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome