Basal cell carcinoma induced by therapeutic radiation for tinea capitis—clinicopathological study

Abstract

BCCs following radiation therapy for tinea capitis show unique histological characteristics related to aggressive behaviour. These aggressive features did not reflect the clinical behaviour in the current cohort.

Scalp BCC's and meningioma following X‐ray epilation for tinea capitis

“…This article is protected by copyright. All rights reserved Consistent with the reported literature [1][2] , in our first case, the interval between irradiation and onset of BCCs was approximately 63 years and meningioma diagnosis was 55 years. It was not possible to determine total dosage of ionising radiation administered to our patients, but the mean dose for the total field reported by other authors ranges between 1-6 Gy, with a mean dose of 1.5Gy.…”

“…Although nodular BCC is the predominant subtype in irradiated patients, there is a relatively high proportion of infiltrative/morpheaform histology and a high frequency of stromal fibroplasia, associated with aggressive growth variants of sporadic BCCs. 2 There are no genetic differences in p53 and PTCH genes in radiation induced versus sporadic BCCs, but mitochondria D-Loop D310 mutation rate is associated with higher radiation doses in subjected patients. 3 Ionising radiation is the only proven causative risk factor for the development of meningioma, even at low doses.…”

Basal cell carcinomas of the scalp after radiotherapy for tinea capitis: Clinicopathological study in a case series of 96 patients with analysis of 427 tumours

“…10 On the other hand, a study by Oshinsky et al showed an apparently good biological behaviour of post-radiotherapy BCCs despite a high proportion of aggressive histological subtypes, contrariwise to what we have observed in our cohort, in which nodular BCCs predominate. 12 To this respect, it is worth mentioning three factors that may introduce bias in our evaluation. First, referral bias is possible due to the fact that our population comes from a tertiary hospital where complicated cases are more likely to be treated.…”

“…It has also been described that BCCs of the scalp arising in this setting demonstrate more aggressive behaviour, with a higher rate of recurrences, often demanding more aggressive surgical excision, 10 although this assertion has been challenged due to methodological issues 11 . Another study found that, despite a high proportion of histologically aggressive cases, there was no apparent aggravation of their biological behaviour 12 …”

“…11 Another study found that, despite a high proportion of histologically aggressive cases, there was no apparent aggravation of their biological behaviour. 12 Even though the association between radiotherapy and BCC risk has been well established for a long time, there are still unanswered questions about these tumours, in particular regarding their underlying oncogenic mechanisms and potential clinicopathological differences in comparison with sporadic BCCs not associated with radiation. There are also contradictory data in the literature regarding the ratio between high-and low-risk histological variants as well as their actual biological behaviour in terms of local invasiveness and potential for recurrence.…”