Bilateral Avascular Necrosis of Sacral Lateral Masses After a Complete Radiological Response of Locally Advanced Rectal Cancer Treated With Neoadjuvant Chemoradiation Therapy. Case Report

Abstract

We present a rare case report of a bilateral avascular necrosis of lateral sacral masses in a patient who developed a sustainable complete clinical and radiological response after chemoradiotherapy for locally advanced rectal cancer. It is shown that despite the standardized and precise planning and fractioning for neoadjuvant chemoradiation therapy for locally advanced rectal cancer, the biological effects of ionizing radiation on critical organs can be va ried both in time of occurrence and in structure. Evaluating the effect of neoadjuvant chemoradiation therapy, one should take into account the possibility of the development of even very rare effects of ionizing radiation on criti cal organs and include their early detection in the diagnostic algorithm.

Case report: Sickle cell anemia avascular necrosis mimicking chronic sacroiliitis in a patient with a pre‐diagnosis of axial spondyloarthropathy

“…In the literature, there is a case report in a patient diagnosed with rectal malignancy who developed bilateral sacral AVN and sacroiliitis during post-chemoradiotherapy and regressed during follow-up. 8 In another study of 410 cases in which radiation-related sacral changes were examined, it was determined that osteoradionecrosis developed in 17% of cases and the majority were transient. 9 Bone marrow necrosis, which is a different entity from avascular necrosis, can be observed in SCA patients and presents with fever (70%), bone pain, and fatigue.…”