Abstract
We describe a case involving a 75-year-old woman presenting with a femur fracture 10 years after radiation therapy for metastatic breast cancer, which developed in the right femur. The lesion showed complete response with bone healing following radiation therapy; however, the patient sustained a femur fracture ten years later. Histological examination of the specimens obtained from the lesion revealed features of radiation osteonecrosis, but there was no histological evidence of tumor. To our knowledge, there has been no reported case of pathological fracture ten years after radiation therapy from radiation osteonecrosis rather than progression of the metastatic lesion. Late complications of radiation therapy should be considered with care, even when metastatic lesions demonstrate complete response to treatment.
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References
Domchek SM, Younger J, Finkelstein DM, Seiden MV: Predictors of skeletal complications in patients with metastatic breast carcinoma.Cancer 89:363–368, 2000.
Fidler M: Prophylactic internal fixation of secondary neoplastic deposits in long bones.Br Med J 1:341–343, 1973.
Keene JS, Sellinger DS, McBeath AA, Engber WD: Metastatic breast cancer in the femur. A search for the lesion at risk of fracture.Clin Orthop 203:282–288, 1986.
Lipton A: Bisphosphonate and breast carcinoma.Cancer 80:1668–1673, 1997.
Aaron AD: Treatment of metastatic adenocarcinoma of the pelvis and the extremities.J Bone Joint Surg Am 79:917–932, 1992.
Van Geffen E, Wobbes T, Veth RP, Gelderman WA: Operative management of impending pathological fractures: a critical analysis of therapy.J Surg Oncol 64:190–194, 1997.
Wedin R, Bauer HC, Wersall P: Failures after operation for skeletal metastatic lesions of long bones.Clin Orthop 358:128–139, 1999.
Hortobagyi GN: Multidisciplinary management of advanced primary and metastatic breast cancer.Cancer 74:416–423, 1994.
Marcial VA: The role of radiation therapy in the multi disciplinary management of recurrent and metastatic breast cancer.Cancer 74:450–452, 1994.
Massin P, Duparc J: Total hip replacement in irradiated hips. A retrospective study of 71 cases.J Bone Joint Surg Br 77:847–852, 1995.
Schurman DJ, Amstutz HC: Orthopedic management of patients with metastatic carcinoma of the breast.Surg Gynecol Obstet 137:831–836, 1973.
LoRusso P: Analysis of skeletal-related events in breast cancer and response to therapy.Semin Oncol 28:22–27, 2001.
Paling MR, Herdt JR: Radiation osteitis: a problem of recognition.Radiology 137:339–342, 1980.
Bragg DG, Shidnia H, Chu FC, Higinbotham NL: The clinical and radiographic aspects of radiation osteitis.Radiology 97:103–111, 1970.
Wedin R, Bauer HC, Rutqvist LE: Surgical treatment for skeletal breast cancer metastases: a population-based study of 641 patients.Cancer 92:257–262, 2001.
Wedin R: Surgical treatment for pathologic fracture.Acta Orthop Scand 72:1–29, 2001.
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Hatano, H., Morita, T., Kobayashi, H. et al. Pathological fracture of the femur ten years after successful radiation therapy for metastatic breast cancer. Breast Cancer 11, 313–317 (2004). https://doi.org/10.1007/BF02984556
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DOI: https://doi.org/10.1007/BF02984556