[Sarcoma of the thoracic wall following mastitis radiotherapy 38 years previously]

A 62-year-old woman presented with a feeling of pressure between her shoulder blades. Physical examination and laboratory test showed no abnormalities. Conventional X-ray of the thorax showed, by chance, a condensation of the second rib. CT scan showed a solitary lesion at the same location. Patient's history mentioned post-partum mastitis 38 years earlier, for which she was treated with X-ray therapy of about 4 to 5 Gray in 1 fraction. A partial rib resection was performed prior to diagnosis. The histopathological diagnosis was stage IA chondrosarcoma. It was excised in toto and an uneventful disease course ensued. In the past, X-ray therapy was used for many different benign diseases. Many doctors nowadays are not aware of this. This case illustrates that radiotherapy for benign disease can give rise to post irradiation sarcomas. Long-term follow-up of an irradiated region is essential for early diagnosis and may lead to higher cure rates.