Abstract
The 59-year-old woman was referred to our hospital with complaint of a mass, 39 mm on the long axis, on her right anterior chest wall. She had undergone thymomectomy followed by 50-Gy radiation therapy 12 years before. Further examinations revealed that this mass was a spindle cell sarcoma arising from the soft tissue around the right sternoclavicular joint. The chest wall, including the tumor, was widely resected and reconstructed with polypropylene mesh, titanium mesh and a bilateral muscle flap. The tumor was histopathogically diagnosed as fibrosarcoma. The resected margin was free from tumor cells. She was discharged on the 34th postoperative day. Eight months later, she had a subcutaneous mass on her left back area. It was resected and diagnosed as a metastatic fibrosarcoma. She underwent two series of chemotherapy using ifosfamide, and to the present day there has been no sign of obvious recurrence. Radiationinduced sarcoma is a rare disease which arises in an irradiated area several years after radiation therapy. Aggressive surgical resection greatly influences life expectancy in patients diagnosed with fibrosarcoma, given that chemotherapy alone is not sufficient for curing the disease and prolonging survival. Regardless, the high recurrence rate of this tumor results in an overall poor prognosis. Further studies should explore the possibility of the use of aggressive surgery combined with chemotherapy in an attempt to improve patient outcome.
