Early Radiation-Induced Sarcoma in an Adolescent Treated for Relapsed Hodgkin Lymphoma with Nivolumab
Lukas Šalaševičius,
Goda Elizabeta Vaitkevičienė,
Ramunė Pasaulienė,
Rosita Kiudelienė,
Ernesta Ivanauskaitė-Didžiokienė,
Donatas Vajauskas,
Nemira Jurkienė,
Jelena Rascon
Affiliations
Lukas Šalaševičius
Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
Goda Elizabeta Vaitkevičienė
Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
Ramunė Pasaulienė
Center for Pediatric Oncology and Hematology, Vilnius University, 08406 Vilnius, Lithuania
Rosita Kiudelienė
Center of Pediatric Oncology and Hematology at Pediatric Department and Hospital of Kauno Klinikos, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
Ernesta Ivanauskaitė-Didžiokienė
National Center of Pathology, 08406 Vilnius, Lithuania
Donatas Vajauskas
Institute of Biomedical Sciences, Department of Radiology, Nuclear Medicine and Medical Physics, Vilnius University, 03101 Vilnius, Lithuanian
Nemira Jurkienė
Radiology Clinic, Nuclear Medicine Department of Kauno Klinikos, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
Jelena Rascon
Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
Radiation-induced sarcoma (RIS) has been reported as a late secondary malignancy following radiotherapy for various types of cancer with a median latency of 10 years. We describe an early RIS that developed in an adolescent within three years of treatment (including PD-L1 check-point inhibitor Nivolumab) of a relapsed classic Hodgkin lymphoma (HL) and was diagnosed post-mortem. The patient died of the progressive RIS that was misleadingly assumed to be a resistant HL based on the positive PET/CT scan. Repetitive tumor biopsies are warranted in cases of aggressive and multi-drug resistant HL to validate imaging findings, ensure correct diagnosis and avoid overtreatment.
