Development of an osteosarcoma following dental extraction after allogeneic stem cell transplantation.

B Phulpin, N Marchettic, L Mansuyd, L Coffinet, C Lucas, G Dolivet, P Chastagner, J Prevost
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Abstract

Objectives: Radio-induced sarcoma is known to occur several years following bone irradiation especially when this treatment is combined to high dose chemotherapy regimens prior to allogeneic haematopoietic stem cell transplantation (HSCT) in very young children. However, little is known about the stimulus of aggressive bony surgery in the development of these tumours.

Material and methods: We report the case of a young girl in whom dental extraction was rapidly followed by the occurrence of a localized tumour 11 years after allogeneic haematopoietic stem cell transplantation using total body irradiation (TBI) for a haemophagocytic lymphophistiocytosis (HLH).

Results: This tumour involved tooth socket and all the right side of the mandible and was diagnosed as an osteogenic osteosarcoma of the zygomatic bone.

Conclusion: This tumour had the characteristics of a radio-induced sarcoma. Thanks to the very short time between the dental extraction and the occurrence of the osteosarcoma at the same location, we discuss the role of the dental extraction as a trigger of osteosarcoma development.

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同种异体干细胞移植后拔牙后骨肉瘤的发生。
目的:已知放射诱导的肉瘤在骨照射后数年发生,特别是在幼童进行同种异体造血干细胞移植(HSCT)前,当放射治疗与高剂量化疗方案联合使用时。然而,对于侵略性骨手术在这些肿瘤发展中的刺激作用知之甚少。材料和方法:我们报告了一名年轻女孩的病例,她在使用全身照射(TBI)治疗噬血细胞性淋巴细胞病(HLH)的同种异体造血干细胞移植11年后,拔牙后迅速发生局部肿瘤。结果:该肿瘤累及牙槽及下颌骨右侧全部,诊断为颧骨成骨性骨肉瘤。结论:该肿瘤具有放射性肉瘤的特征。由于拔牙和同一部位发生骨肉瘤之间的时间很短,我们讨论了拔牙作为骨肉瘤发展的触发因素的作用。
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