Postirradiation osteosarcoma in childhood

Three cases of postirradiation osteosarcoma which presented in childhood are reported and the pertinent literature reviewed. The children had been treated in each instance before the age of 3 years for an astrocytoma, retinoblastoma, and neuroblastoma, respectively. An average latent interval of 9.5 years lapsed before the osteosarcomas were diagnosed. Two of the tumors occurred in unusual sites, the cervical vertebrae and maxilla but were within the fields of prior irradiation. The tumors were predominantly sclerotic and were high-grade osteosarcomas. Only one patient has remained free of disease after treatment. One tumor-related death has occurred and the third patient has had two wedge resections of pulmonary metatases.