Thorotrast‐associated sarcoma of bone. A case report and review of the literature

An osteosarcoma developed near the right lesser trochanter of a 55‐year‐old woman. The neoplasm fulfilled the generally accepted criteria for a Thorotrast related malignancy. Strengthening this relationship was the occurrence of the tumor in an unusual location and uncommon age group. Thorium was confirmed both in the tumor and in bone marrow histiocytes by its characteristic x‐ray spectrum. Including this case only twelve Thorotrast‐associated neoplasms of bone have been reported. The mean latency period after Thorotrast administration was 26 years. Regression analysis revealed that latency period and Thorotrast dose are inversely related. All tumors were reported to be sarcomas. Six osteosarcomas, one fibrosarcoma, one chondrosarcoma, and one undifferentiated sarcoma were proven histologically. All patients, for whom follow‐up was given, had died of the tumor. The reasons behind the low frequency of reported Thorotrast‐associated bone malignancies may be the low concentration of 232Th and radioactive daughters in bone, long latency period or the general lack of knowledge concerning the possible relationship between Thorotrast and bone tumors. Statistical association between Thorotrast injection and bone sarcoma is shown. The criteria for the diagnosis of Thorotrastosis are discussed as well as the long term deleterious effects. The distribution of Thorotrast within the body is discussed as well as the associated radiographic changes.

[1]  K. Ishak,et al.  Evolution of thorotrast-induced hepatic angiosarcomas. , 1979, Environmental research.

[2]  C. W. Mays,et al.  Bone tumors in thorotrast patients. , 1979, Environmental research.

[3]  J. Horta,et al.  Movement of thorotrast aggregates in the bone marrow. , 1979, Environmental research.

[4]  G. van Kaick,et al.  Malignancies in German thorotrast patients and estimated tissue dose. , 1978, Health physics.

[5]  C. W. Mays Endosteal dose to thorotrast patients. , 1978, Health physics.

[6]  M. Tavares,et al.  Malignancies in Portuguese thorotrast patients. , 1978, Health physics.

[7]  K. Okuda,et al.  Minimal Thorotrast deposition in parapancreatic lymph nodes. , 1976, Radiology.

[8]  L. Hartman,et al.  Thorotrast‐induced extraskeletal osteosarcoma of the cervical region. Report of a case , 1975, Cancer.

[9]  M. Mollá Radionuclides in the autopsy samples from thorotrast patients. , 1975, Health Physics.

[10]  C. da Motta,et al.  Thorium dioxide effects in man. Epidemiological, clinical, and pathological studies (experience in Portugal). , 1974, Environmental research.

[11]  B. Gondos Late clinical and roentgen observations following Thorotrast administration. , 1973, Clinical radiology.

[12]  H. Battifora,et al.  Thorotrast‐induced hepatoma , 1972, Cancer.

[13]  M. J. Flynn,et al.  Effects of long-term thorotrast exposure. , 1972, Radiology.

[14]  H. F. Lucas,et al.  Osteogenic sarcoma in a patient injected with Thorotrast. , 1972, The Journal of bone and joint surgery. American volume.

[15]  M. Tavares,et al.  Some clinical and laboratory findings in patients injected with thorium dioxide. Study of 155 cases. , 1972, The American journal of gastroenterology.

[16]  T. A. Bensinger,et al.  Thorotrast-induced reticuloendothelial blockade in man. Clinical equivalent of the experimental model associated with patent pneumococcal septicemia. , 1971, The American journal of medicine.

[17]  T. Monath,et al.  Effects of thorotrast on humoral antibody, viral multiplication, and interferon during infection with St. Louis encephalitis virus in mice. , 1971, The Journal of infectious diseases.

[18]  W. J. Meredith,et al.  Book Review: A Review of the Radiosensitivity of the Tissues in Bone , 1969 .

[19]  P. Gardner,et al.  Application of Immunofluorescent Antibody Technique in Rapid Diagnosis of Respiratory Syncytial Virus Infection , 1968, British medical journal.

[20]  R. Carrigan MANUFACTURE OF THORIUM DIOXIDE SUSPENSION (THOROTRAST) , 1967, Annals of the New York Academy of Sciences.

[21]  L. Larsson,et al.  LATE EFFECTS OF THOROTRAST IN CEREBRAL ANGIOGRAPHY , 1967, Annals of the New York Academy of Sciences.

[22]  R. A. Dudley A SURVEY OF RADIATION DOSIMETRY IN THORIUM DIOXIDE CASES , 1967, Annals of the New York Academy of Sciences.

[23]  N. Telles FOLLOW‐UP OF THORIUM DIOXIDE PATIENTS IN THE UNITED STATES , 1967, Annals of the New York Academy of Sciences.

[24]  W. Looney,et al.  DISTRIBUTION OF THORIUM DAUGHTERS IN BONE * , 1967, Annals of the New York Academy of Sciences.

[25]  W. Wenz [THOROTRAST TUMORS. QUANTITATIVE STUDIES ON THE DOSE-EFFECT PROBLEM IN THOROTRASTOSIS]. , 1964, Ergebnisse der Chirurgie und Orthopadie.

[26]  T. Tanaka,et al.  FOUR CASES OF THOROTRAST INJURY AND ESTIMATION OF ABSORBED TISSUE DOSE IN CRITICAL ORGANS. , 1963, Journal of radiation research.

[27]  S. Dahlgren Thorotrast tumours. A review of the literature and report of two cases. , 2009, Acta pathologica et microbiologica Scandinavica.

[28]  Looney Wb AN INVESTIGATION OF THE LATE CLINICAL FINDINGS FOLLOWING THOROTRAST (THORIUM DIOXIDE) ADMINISTRATION , 1960 .