Salivary gland second cancer after bone sarcoma treatment

Second malignant neoplasms (SMN) or second cancers may occur in 2-5 % of childhood cancer survivors within 5-25 years after diagnosis and treatment of a bone sarcoma. The most common are leukemia and breast cancer; salivary gland SMN are exceptional. To enhance the literature, we reviewed our patients with bone sarcomas and evaluated the incidence and outcome of salivary gland SMN.

We retrospectively studied all patients with osteosarcoma and Ewing's sarcoma treated at the Istituto Ortopedico Rizzoli with chemotherapy from January 1983 to December 2012. There were 883 osteosarcoma and 543 Ewing's sarcoma patients. We evaluated the date of diagnosis and histology of bone sarcoma, chemotherapy administered, date of diagnosis and histology of SMN, and survival of patients.

The 10-year incidence of SMN was 3.6 %; the most common were breast cancer, leukemia, sarcomas, and salivary gland neoplasms. The incidence of salivary gland SMN was 0.5 %; there were five male and two female patients with a mean age of 19 years (range 13-28 years) who experienced a salivary gland SMN within a mean interval of 79 months (range 51-97 months). The most common salivary gland involved was the parotid followed by the submandibular gland. One of the seven patients with salivary gland SMN died from his SMN.

Treating physicians should be aware of the risk of salivary gland SMN after chemotherapy for bone sarcomas in children and adolescents. Close follow-up of childhood bone sarcoma survivors for SMN is important.