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Radiation Therapy

Recurrent BCC of the External Ear After Radiation

HISTORY A 77-year-old man presents with 5-year history of infiltrative basal cell carcinoma (BCC) of the left ear fossa triangularis and root of helix. The area was originally treated with four weeks of radiation in 2014, complicated by temporary ulceration and healing with adhesion. When the area developed crusting a couple of years later, the…

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Lethal Squamous Cell Carcinoma of the Forearm in a Lung Transplant Recipient

HISTORY A 71-year-old lung transplant recipient presented with a recurrence of left dorsal forearm and wrist Squamous Cell Carcinoma (SCC) after Mohs excision in 2016 performed elsewhere. The patient underwent Mohs excision with clear margins and additional deeper wide local resection with no carcinoma identified. Patient was referred for radiation oncology evaluation, but he was…

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Multiple Nasal Basal Cell Carcinomas

HISTORY 81-year-old man presents with 7-month history of two nasal tip and right nasal ala BCC’s. All three lesions were treated with 2 adjoining SRT fields. The course began 1-8-18 and completed by 1-26-18 after 15 treatments. DISCUSSION This patient represents an excellent candidate for radiation therapy. Electron beam radiation therapy can be used with…

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Large Thigh BCC Treated with Radiation

HISTORY 92-year-old man presents with 15-year history of basal cell carcinoma on left thigh. The 9.3 cm x 8.6 cm superficial plaque was treated with electron beam radiotherapy completing 6000 cGy in 30 fractions on 3-13-2018. DISCUSSION The 6-week course of radiation was tolerated well by this patient. He had minimum oozing from previous biopsy…

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Large BCC of Thigh

HISTORY   92-year-old man presents with 15 year history of basal cell carcinoma on left thigh. The cancer is now a 9.3 cm x 8.6 cm superficial plaque with a few ulcerations.  Patient is being evaluated for treatment with superficial radiation therapy.       DISCUSSION   Large  superficial basal cell carcinomas of the skin…

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EXTENSIVE NASAL TIP BASAL CELL CARCINOMA

HISTORY 71-year-old woman presents with a nasal tip lesion biopsied on 6/12/2017 showing basal cell carcinoma, superficial and micronodular type. There is a history of treatment with topical chemotherapy and Mohs excision of other sites. Patient is anxious about the possible extent of nasal carcinoma and the reconstruction required. DISCUSSION This case presents an excellent…

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Deeply Invasive Squamous Cell Carcinoma of Cheek

  HISTORY: 82-year-old man with a 1 year history of squamous cell carcinoma on the right lower cheek biopsied on 4/28/2017. Radical resection of the right cheek carcinoma and deep facial lymph node biopsy was performed. Intraoperative Mohs margin evaluation confirmed clear margins. Final permanent histology margins were close but clear. Evidence of perineural invasion…

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RECURRENT SCALP MELANOMA WITH CALVARIAL METASTASES

HISTORY 85-year-old man presented in 4/2016 with a 4 month history of a nonhealing scalp wound following excision of melanoma done in 2014, then additional excision with skin graft closure followed by radiation completed in June 2015.  The wound developed skin breakdown and osteoradionecrosis treated with serial outer table of calvarium debridements. Recent biopsy on…

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Osteoradionecrosis of Skull

HISTORY 85-year-old man presented in 4/2016 with a 4 month history of a nonhealing scalp wound following excision of melanoma, radiation, and two failed skin grafts. Patient was treated with serial outer table of calvarium debridements – 4/2016, 7/2016, 11/2016. Patient had a consultation with UCI team for full thickness calvarial resection and microvascular reconstruction.…

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Lower Leg Radiation Ulcer Treatment

Lower Leg Radiation Ulcer

HISTORY 85-year-old man presented in March 2015 with a multi-year history of a non-healing right lower leg lesion. Shave biopsy found squamous cell carcinoma in situ with focal areas of early invasion. Superficial radiotherapy was prescribed at 50 kvp 5 days per week for 5 weeks ending in July 2015. Minor skin erosion present 3…

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