{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:46:06Z","timestamp":1782708366205,"version":"3.54.5"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To report a rare case of a patient with adult rhabdomyosarcoma (RMS) in the craniofacial region who developed a very late-stage left maxillofacial cavity after 16 years of multimodal treatment, and to systematically investigate the potential causal relationship between this complication and previous radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A detailed report is presented on the diagnosis and treatment process of a 46-year-old female patient. A comprehensive evaluation framework was employed to analyze causality, encompassing temporal correlation, spatial alignment with the original radiation field, exclusion of alternative etiologies, and biological plausibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Approximately 16 years after the initial radiotherapy, the patient developed soft tissue defects and cavity formation in the core area of the original high-dose irradiation field. Although tissue biopsy was not performed due to post-radiotherapy site bleeding and patient constitution risks, imaging studies showed a high degree of consistency between the lesion and the previous radiotherapy area, with no evident evidence of tumor recurrence or primary infection, consistent with the pathophysiological process of radiation-induced tissue necrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the exceedingly long latency period, based on the conclusive spatial correlation, reasonable exclusion of other etiologies, and well-established radiobiological mechanisms, there is a \u201chighly probable\u201d causal relationship between the maxillofacial cavity and previous radiotherapy. This case serves as a warning that for long-term surviving RMS patients, extremely late radiation injury represents a serious complication risk that cannot be ignored.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1765985","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:26:52Z","timestamp":1782707212000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["An ultra-late maxillofacial cavity following multimodal treatment for adult head and neck rhabdomyosarcoma: a case report with a 16-year follow-up"],"prefix":"10.3389","volume":"16","author":[{"given":"Wanhui","family":"Dong","sequence":"first","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine","place":["Jinan, Shandong, China"]},{"name":"Department of Oncology, Anhui University of Traditional Chinese Medicine Affiliated Lu'an Traditional Chinese Medicine Hospital","place":["Lu\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Anhui University of Traditional Chinese Medicine Affiliated Lu'an Traditional Chinese Medicine Hospital","place":["Lu\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Oncology, Anhui University of Traditional Chinese Medicine Affiliated Lu'an Traditional Chinese Medicine Hospital","place":["Lu\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Anhui University of Traditional Chinese Medicine Affiliated Lu'an Traditional Chinese Medicine Hospital","place":["Lu\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Anhui University of Traditional Chinese Medicine Affiliated Lu'an Traditional Chinese Medicine Hospital","place":["Lu\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaidong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shandong University of Traditional Chinese Medicine Affiliated Hospital","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5211","article-title":"Pediatric rhabdomyosarcoma incidence and survival in the United States: An assessment of 5656 cases, 2001-2017","volume":"12","author":"McEvoy","year":"2023","journal-title":"Cancer 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