Dermoscopy of multiple radiation-induced basal cell carcinomas in a patient treated previously for pinealoma

Abstract

Background: Malignancies secondary to radiation, such as radiation-induced skin cancer, are possible consequences of radiation therapy. The most frequent postradiation skin neoplasm is basal cell carcinoma. Main observations:We report a case of a 49-year-old woman who underwent multiple radiotherapy sessions for pinealoma and developed post-radiation alopecia. After 26 years the patient noticed the emergence of eighteen superficial scalp lesions in the previously irradiated areas. Dermoscopy showed predominance of ovoid nests and presence of arborizing vessels on pink background, consistent with basal cells carcinoma. The diagnosis was confirmed by histopathology. Conclusion:There is an absolute need to guide patients through the possible late adverse events of radiotherapy. Regular dermoscopy examinations should be performed, especially in areas previously exposed to radiation. (J Dermatol Case Rep.

Hair disorders in cancer survivors

“…Occipital, parietal, and temporal scalp are commonly focal sites of radiotherapy for brain metastases and central nervous system tumors such as glioblastoma and astrocytoma 43 ( Figure 2). Diffuse pRIA is also described with whole brain radiotherapy for brain metastases, 44,45 especially when combined with chemotherapy. 46 In addition, pRIA could be also observed in any other hairbearing area were radiotherapy is received, such as the face, neck, 47 or the extremities in patients with other solid tumors.…”

Secondary basal cell carcinoma of scalp after radiotherapy

“…There are reports of intervals of up to 64 years between the exposure to radiation and the emergence of second cancer, suggesting that the risk of carcinogenesis on the irradiated skin persists throughout the patient's entire life. [ 9 ] Although radiation exposure is a well-established risk factor for developing secondary malignancy; however, estimating the true incidence of RT-induced secondary malignancy is difficult, for there are many other risk factors that are related to cancer formation. [ 10 ] The diagnosis of RT-induced malignancy should be made under strict consideration and other possible risk factors must be excluded.…”

“…[ 20 ] However, the findings of demoscopy and gene expression between BCC in irradiated patients and BCC in nonirradiated patients showed no obvious difference. [ 9 , 21 ] The treatment for RT-induced BCC tends to be more intense for it is prone to recurrence. Besides surgical excision, there are some target therapies approved for the treatment of such aggressive BCC.…”