Unusual second malignancies following radiation therapy: subcutaneous pleomorphic rhabdomyosarcoma and cutaneous melanoma. Two case reports

J Cutan Pathol. 2000 Sep;27(8):419-22. doi: 10.1034/j.1600-0560.2000.027008419.x.

Abstract

Background: Among nonepithelial second neoplasms which are known to be induced by irradiation, rhabdomyosarcomas are extremely rare, and melanomas are infrequent. We report a high-grade sarcoma with rhabdomyoblastic differentiation, which appeared 30 years after megavoltage irradiation for an endometrial adenocarcinoma, and a malignant melanoma which arose after 6 years in the irradiation field of a fibrosarcoma.

Methods: Histology and immunohistochemistry were performed in both cases. In the first case, electron microscopy was also performed. In the second, the previous tumor was re-evaluated.

Results: The first case showed histological, immunohistochemical and ultrastructural features of a rhabdomyosarcoma. In the second case, a lentigoid malignant melanoma was histologically and immunohistochemically demonstrated, whereas the previously resected tumor was a fibrosarcoma negative to melanoma markers.

Conclusions: Rare cases of rhabdomyosarcomas and melanomas are induced by irradiation, although in some cases other factors (i.e., genetic risk, chemotherapy) may have a prominent etiopathogenetic role in their development. A close follow-up and a careful examination of the irradiated area should facilitate an early diagnosis of these aggressive postradiation second neoplasms.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / radiotherapy*
  • Aged
  • Biomarkers, Tumor / analysis
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / radiotherapy*
  • Fatal Outcome
  • Female
  • Fibrosarcoma / pathology
  • Fibrosarcoma / radiotherapy*
  • Humans
  • Immunohistochemistry
  • Melanoma / chemistry
  • Melanoma / etiology*
  • Melanoma / pathology
  • Middle Aged
  • Neoplasm Proteins / analysis
  • Neoplasms, Radiation-Induced / chemistry
  • Neoplasms, Radiation-Induced / etiology*
  • Neoplasms, Radiation-Induced / pathology
  • Radiotherapy, High-Energy
  • Rhabdomyosarcoma / chemistry
  • Rhabdomyosarcoma / etiology*
  • Rhabdomyosarcoma / secondary
  • Skin Neoplasms / chemistry
  • Skin Neoplasms / etiology*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / radiotherapy*

Substances

  • Biomarkers, Tumor
  • Neoplasm Proteins