Management of recurrent alveolar soft‐part sarcoma of the tongue after external beam radiotherapy with iodine‐125 seed brachytherapy

Background Alveolar soft part sarcoma (ASPS) is a rare type of soft tissue sarcoma. The infrequency of ASPS is such that it accounts for <1% of all soft tissue sarcomas and <0.1% of sarcomas concerning the head and neck, primarily those involving the orbit (48%) and tongue (25%). Traditional chemotherapy or radiotherapy of ASPS is often associated with poor outcome, even after comprehensive interventions. Methods and Results We performed iodine‐125 ( 125 I) seed brachytherapy under ultrasound guidance through a submandibular puncture in a 4‐year‐old boy with recurrent ASPS of the tongue. The prescription dose was 120 Gy; therefore, 35 125 I seeds were implanted with 0.77 mCi per seed, the total amount of activity being 26.95 mCi. CT scans confirmed a complete response after the treatment. Conclusion Our patient now has a recurrent‐free survival of >30 months, an amount of time longer than the median rate described in the literature. © 2014 Wiley Periodicals, Inc. Head Neck 36: E125–E128, 2014