Radiation Therapy
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
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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History of Radiotherapy in Dermatology
Radiotherapy was born shortly after discovery of radiation by the Marie Curie and Peter Curie in 1889. First report of radiotherapy used for malignancy was published in 1896 in Medical Record by Victor Despeignes who treated a patient with gastric cancer in France. Émil Grubbé, a medical student in Chicago at the time, would later…
Read MoreRadiation Carcinogenesis
As acceptance of radiation therapy for skin cancer grows, questions arise as to the long-term risks therapeutic radiation poses. This is an area extensively measured and studied by radiation physicists and medical dosimetrists. However, from practical point of view, most of empirical data comes form epidemiological population studies. The most dramatic of these being atomic…
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Superficial Radiotherapy – An Alternative Treatment of Superficial Carcinomas
First successful treatment of skin cancer with fractionated radiation therapy was reported by Steinbeck and Sjogren in Sweden in 1899. Since then, superficial radiation and low energy Grenz X-rays have been utilized in office settings by radiation oncologists and dermatologists for the same purposes. In the United States, the practice continued through the 1970’s and…
Read MoreLong Term Radiation Consequences
This month we presented a case of radiation dermatitis some 20+ years following radiation treatment of skin carcinoma. This case had the classic presentation of a dry ulcer surrounded by atrophic hypopigmented skin. Clearly, incisional biopsy is recommended to differentiate this from a delayed radiation-induced malignancy. This delayed presentation of radiation dermatitis is unusual and…
Read MoreRadiation Therapy of Skin Cancer: Dosing and Complications
Although, radiation of ear carcinomas can pose a risk of chondritis and poor healing, that risk can be virtually eliminated with lower dose fractions (radiation dose per treatment) spread over a longer course. Total dose requirement for skin cancer treatment ranges from 3500 cGy to 6000 cGy depending on the size and depth of the…
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