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Radiation-induced focal cortical necrosis of the femur presenting as a lytic lesion

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Abstract

Management of soft tissue sarcomas is often complicated, requiring radiation before and in some cases after limb-sparing surgery. Radiation necrosis is a severe complication after radiation treatment and is typically dose related and involves medullary bone. We report on two cases of hitherto unreported focal circumscribed intra-cortical lytic lesions within the radiation portal, which appeared 19 months and 31 months, respectively, after the conclusion of radiation treatment. Both patients had a history of soft tissue sarcoma treated with radiation (66 Gy) and surgical resection. Biopsy of these lesions showed necrotic bone attributed to radiation.

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Authors and Affiliations

  1. Musculoskeletal Radiology, Cleveland Clinic, A-21 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Hakan Ilaslan & Jean Schils

  2. Orthopedic Oncology, Cleveland Clinic, A-21 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Michael Joyce

  3. Radiation Oncology, Cleveland Clinic, A-21 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Chirag Shah

  4. Pathology, Cleveland Clinic, A-21 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Yaxia Zhang

Authors
  1. Hakan Ilaslan
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  2. Jean Schils
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  3. Michael Joyce
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  4. Chirag Shah
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  5. Yaxia Zhang
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Correspondence to Hakan Ilaslan.

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Ilaslan, H., Schils, J., Joyce, M. et al. Radiation-induced focal cortical necrosis of the femur presenting as a lytic lesion. Skeletal Radiol 46, 1579–1584 (2017). https://doi.org/10.1007/s00256-017-2715-5

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  • DOI: https://doi.org/10.1007/s00256-017-2715-5

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