Track
Case ReportsAbstract
Radiation-induced sarcomas are a rare, latent complication of radiotherapy. Cutaneous pleomorphic sarcomas following radiation therapy are only occasionally encountered. A 59-year-old male with a history of prostatic adenocarcinoma status post radical prostatectomy and radiation 11 years ago presented with an ulcerated, firm nodule of 2.0 cm on the right buttock. The tumor had grown to 4.3 cm when it was excised two months later. Biopsy revealed an undifferentiated, pleomorphic, epithelioid and spindle cell sarcoma in the dermis and subcutaneous fat. This distinct hypercellular sarcoma is composed of atypical spindle and epithelioid cells arranged in solid sheets and fascicles with a high mitotic count. Small foci with a hint of vascular differentiation, highlighted on D2-40 stain, are noted. The patient received a total dose of 71.3 Gy of radiation for his prostatic adenocarcinoma. It has been documented that latency periods for radiation‑induced sarcomas range from 4 to over 20 years after treatment, with a median of 10 to 14 years. Radiation-induced sarcomas arising in or near the prostate after treatment for prostate cancer are rare complications (estimated <0.2% risk). Most documented sarcoma cases following radiation for prostatic carcinoma occur in the pelvic or perineal region as primarily malignant fibrous histiocytomas and osteosarcomas. To our knowledge, this is the first reported case of a cutaneous undifferentiated sarcoma following radiation treatment for prostatic adenocarcinoma.