Radiation-induced tibial sarcoma in a treated case of hind foot angiomatosis

Hemangiomatosis with osteolysis, osteosclerosis and loss of bony definition is an uncommon disease entity. Many forms of treatment have been used, varying almost from case to case. The use of radiation therapy has proved successful in the control of the disease process in reported cases. The current case of hind foot hemangiomatosis went on to develop sarcoma 17 years later in the uninvolved tibia at the margin of the radiation field, which proved to be fatal to the patient. Treatment by radiotherapy had permitted normal function for 15 years. This case highlights the difficulties of management of skeletal angiomatosis based on anatomic location and emphasizes the need for judicious planning and selection of the mode of delivery of radiotherapy.