The difficult management of radio-incuced head and neck sarcomas

Sarcomas are defined as "radio-induced" (RIS) when the histology is distinct from the primary lesion, when they arise in the irradiation field within several years (mean time: 10yrs) from radiation exposure [1,2]. Nevertheless, due to the lack of specific diagnostic criteria between radiation-induced sarcomas and sporadic sarcomas arising within the radiation field, some authors prefer to refer to these lesions as 'sarcomas in irradiated tissue' rather than 'radiation-induced sarcomas' [1,2], though the tissue morphology close to the lesion may be suggestive if radiation-related changes are shown (e.g., dense cellular fibrosis, atypical fibroblasts, alteration of the vascular architecture, and abundant fibrous stroma in the dermis adjacent to the sarcoma).

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