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Radiation-induced sarcoma presenting as a gluteal abscess: a diagnostic and therapeutic challenge
  1. Sudharshan Mahalingam1,
  2. Sudharsanan Sundaramurthi1,
  3. Balamourougan Krishnaraj2 and
  4. Sarath Chandra Sistla1
  1. 1Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India
  2. 2Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Sudharsanan Sundaramurthi; sudharsanans4{at}gmail.com

Abstract

Sarcomas are a rare and fatal treatment complication following radiotherapy. Radiation-induced sarcomas (RISs) presenting as a gluteal abscess is a rarity, accounting for its varied presentation. We present a case of a middle-aged woman, post-chemo-radiation for carcinoma cervix 5 years ago, who presented with gluteal abscess. Achieving haemostasis post incision and drainage under anaesthesia was a challenge. On further evaluation, she was diagnosed with radiation-induced gluteal soft tissue sarcoma. Haemostasis was achieved after radiation following failed attempts of surgical and radiological interventions. She is currently planned for chemotherapy. Cancer survivors have an increased risk of developing a second malignancy following radiation treatment. RISs are highly aggressive, exhibit a varied clinical presentation and pose a challenge in early diagnosis; thus, have a poor outcome. RISs pose a diagnostic challenge; any dubious lesion in the previously irradiated field should raise suspicion and prompt aggressive management.

  • cervical cancer
  • radiotherapy
  • pathology
  • pain (palliative care)
  • interventional radiology

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Footnotes

  • Contributors Substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of findings: SM. Drafting the work or revising it critically for important intellectual content: BK. Final approval of the version published: SCS. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: SS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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