skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Fibrosarcoma after high energy radiation therapy for pituitary adenoma

Abstract

Pituitary sarcoma is a rare late complication of radiotherapy for pituitary tumors. Although early case reports involved multiple courses of relatively low-energy radiation therapy, pituitary sarcoma has been seen with single courses of high-energy x-ray or heavy particle radiotherapy. This report describes a fibrosarcoma of the pituitary occurring 5 years after 4,500 rad (45 Gy) of x-irradiation delivered in 20 treatments over 3 weeks by an 8 MeV linear accelerator.

Authors:
 [1]; ; ;
  1. (Univ. of Virginia Medical Center, Charlottesville, VA)
Publication Date:
OSTI Identifier:
7056844
Resource Type:
Journal Article
Resource Relation:
Journal Name: Am. J. Roentgenol.; (United States); Journal Volume: 135:5
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; 62 RADIOLOGY AND NUCLEAR MEDICINE; FIBROSARCOMAS; RADIOINDUCTION; PITUITARY GLAND; DELAYED RADIATION EFFECTS; ADENOMAS; MEV RANGE 01-10; PATIENTS; RADIOTHERAPY; SIDE EFFECTS; X RADIATION; BIOLOGICAL EFFECTS; BIOLOGICAL RADIATION EFFECTS; BODY; DISEASES; ELECTROMAGNETIC RADIATION; ENDOCRINE GLANDS; ENERGY RANGE; GLANDS; IONIZING RADIATIONS; MEDICINE; MEV RANGE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIATION EFFECTS; RADIATIONS; RADIOLOGY; SARCOMAS; THERAPY; 560151* - Radiation Effects on Animals- Man; 550603 - Medicine- External Radiation in Therapy- (1980-)

Citation Formats

Martin, W.H., Cail, W.S., Morris, J.L., and Constable, W.C. Fibrosarcoma after high energy radiation therapy for pituitary adenoma. United States: N. p., 1980. Web. doi:10.2214/ajr.135.5.1087.
Martin, W.H., Cail, W.S., Morris, J.L., & Constable, W.C. Fibrosarcoma after high energy radiation therapy for pituitary adenoma. United States. doi:10.2214/ajr.135.5.1087.
Martin, W.H., Cail, W.S., Morris, J.L., and Constable, W.C. 1980. "Fibrosarcoma after high energy radiation therapy for pituitary adenoma". United States. doi:10.2214/ajr.135.5.1087.
@article{osti_7056844,
title = {Fibrosarcoma after high energy radiation therapy for pituitary adenoma},
author = {Martin, W.H. and Cail, W.S. and Morris, J.L. and Constable, W.C.},
abstractNote = {Pituitary sarcoma is a rare late complication of radiotherapy for pituitary tumors. Although early case reports involved multiple courses of relatively low-energy radiation therapy, pituitary sarcoma has been seen with single courses of high-energy x-ray or heavy particle radiotherapy. This report describes a fibrosarcoma of the pituitary occurring 5 years after 4,500 rad (45 Gy) of x-irradiation delivered in 20 treatments over 3 weeks by an 8 MeV linear accelerator.},
doi = {10.2214/ajr.135.5.1087},
journal = {Am. J. Roentgenol.; (United States)},
number = ,
volume = 135:5,
place = {United States},
year = 1980,
month =
}
  • A patient who received postoperative radiation therapy for the treatment of a chromophobe adenoma developed a fibrosarcoma of the pituitary gland region 10 years later. A single course of irradiation was given with a total dose to the pituitary of 4092 rad in 21 fractions and 29 days using cobalt-60 radiation at a source to skin distance of 80 cm.
  • Eight years after radiation therapy (5000 rads of 60Co) for a pituitary adenoma, a patient developed a sellar fibrosarcoma. The tumor had an aggressive growth pattern: it infiltrated the optic nerve, sphenoidal air sinus, hypothalamus, and both cavernous sinuses, where compression of the left internal carotid artery resulted in a massive hemispheric infarction. Surgery was ineffective in arresting rapid growth of the lesion; death occurring 5 months after onset of symptoms.
  • Purpose: To assess and compare the incidence of stroke and stroke subtype in pituitary adenoma patients treated with postoperative radiation therapy (RT) and surgery alone. Methods and Materials: A cohort of 462 pituitary adenoma patients treated between 1959 and 2008 at the University Medical Center Groningen in The Netherlands was studied. Radiation therapy was administered in 236 patients. The TOAST (Trial of ORG 10172 in Acute Stroke Treatment) and the Oxfordshire Community Stroke Project classification methods were used to determine causative mechanism and anatomic localization of stroke. Stroke incidences in patients treated with RT were compared with that observed aftermore » surgery alone. Risk factors for stroke incidence were studied by log–rank test, without and with stratification for other significant risk factors. In addition, the stroke incidence was compared with the incidence rate in the general Dutch population. Results: Thirteen RT patients were diagnosed with stroke, compared with 12 surgery-alone patients. The relative risk (RR) for stroke in patients treated with postoperative RT was not significantly different compared with surgery-alone patients (univariate RR 0.62, 95% confidence interval [CI] 0.28-1.35, P=.23). Stroke risk factors were coronary or peripheral artery disease (univariate and multivariate RR 10.4, 95% CI 4.7-22.8, P<.001) and hypertension (univariate RR 3.9, 95% CI 1.6-9.8, P=.002). There was no difference in TOAST and Oxfordshire classification of stroke. In this pituitary adenoma cohort 25 strokes were observed, compared with 16.91 expected (standard incidence ratio 1.48, 95% CI 1.00-1.96, P=.049). Conclusions: In pituitary adenoma patients, an increased incidence of stroke was observed compared with the general population. However, postoperative RT was not associated with an increased incidence of stroke or differences in causative mechanism or anatomic localization of stroke compared with surgery alone. The primary stroke risk factor was pre-existent coronary or peripheral artery disease.« less
  • A 26-year-old woman was treated for a prolactin secreting pituitary adenoma by surgery and radiotherapy (5860 rads). Fourteen months later, she developed right hemiparesis and dysarthria. A T1-weighted magnetic resonance imaging scan using gadolinium contrast showed a small, enhanced lesion in the upper pons. Seven months later, she had a sudden onset of loss of vision, and radiation optic neuropathy was diagnosed. A T1-weighted magnetic resonance imaging scan showed widespread gadolinium-enhanced lesions in the optic chiasm, optic tract, and hypothalamus. Magnetic resonance imaging is indispensable for the early diagnosis of radiation necrosis, which is not visualized by radiography or computedmore » tomography.« less