Interesting ImageFulminant Postirradiation Soft Tissue SarcomaHsieh, Te-Chun MD*; Kao, Chia-Hung MD*§; Wu, Yu-Chin MD*; Hsu, Cheng-Nan MD†; Wang, Chih-Hsiu MD*; Lin, Yu-Yi MD*; Yen, Kuo-Yang RT*; Sun, Shung-Shung MD*‡Author Information From the *Department of Nuclear Medicine and PET Center, China Medical University, Taichung, Taiwan; †Department of Radiology, China Medical University Hospital, Taichung, Taiwan; §School of Medicine, China Medical University; and ‡Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan. Received for publication December 31, 2008; revision accepted June 10, 2009. Reprints: Shung-Shung Sun, MD, Department of Nuclear Medicine and PET Center, China Medical University Hospital, No. 2, Yuh-Der Rd, Taichung 404, Taiwan, Republic of China. E-mail: [email protected]. Clinical Nuclear Medicine: November 2009 - Volume 34 - Issue 11 - p 811-814 doi: 10.1097/RLU.0b013e3181b7d994 Buy Metrics Abstract A 49-year-old man had a secondary primary esophageal squamous cell carcinoma that was treated with neoadjuvant concurrent chemoradiotherapy (CCRT). An unexpected fulminant postirradiation malignant fibrous histiocytoma developed in the irradiation field 2 months after the CCRT. After esophagectomy and adjuvant radiation therapy, widespread disease still occurred in 2 months and he died of tumor bleeding 2 months later. The serial diagnostic images were compared and revealed that fluoro-deoxy-glucose positron emission tomography (FDG PET) was more useful in distinguishing post-therapeutic change and tumor recurrence in the region after surgical and radiation therapy. This report is of a postirradiation sarcoma with a very short latent period. © 2009 Lippincott Williams & Wilkins, Inc.