Radiation-induced intra- and extra-cranial high-grade myxofibrosarcoma with tumor bleeding

Radiation-induced secondary malignant neoplasms in central nervous system tumor survivors have become a problem of increasing concern over the last 20 years because of rare but serious and potentially fatal complications. Herein, we report the case of a 28-year-old man who presented with a left fronto-temporal intra- and extra-cranial tumor with intra-tumor bleeding at the site of previous radiotherapy in May 1991. He underwent craniotomy with gross total removal of the tumor and surrounding hematoma in August 2005. The tumor was a high-grade malignant myxofibrosarcoma (Fédération Nationale des Centres de Lutte Contre le Cancer Grade III [out of III]). Radiation-induced malignant myxofibrosarcoma with tumor bleeding is an infrequent complication of radiotherapy. Although rare, it should always be kept in mind with regards to the differential diagnosis of a lesion that develops several years after radiation therapy. Also, follow-up of patients that have undergone radiation therapy should be long-term.