Radiation-induced Osteosarcoma of the vaginal vault following cervical cancer treatment

A woman in her 60s with a prior history of cervical carcinoma treated with chemoradiation presented with a polypoidal vaginal lesion nearly 7 years after initial therapy. Histopathology confirmed osteosarcoma confined to the posterior vaginal wall, with imaging excluding metastases. Total vaginectomy was performed, and final diagnosis was radiation-induced vaginal osteosarcoma. Although adjuvant chemotherapy was recommended, the patient declined. 6 months later, local recurrence and lung metastases developed. This case highlights the rare occurrence of radiation-induced osteosarcoma at the vaginal vault, emphasising the importance of long-term surveillance following pelvic radiotherapy for gynaecological malignancies.