Post radiation skin tumors: basal cell carcinomas, squamous cell carcinomas and angiosarcomas. A review of this late effect of radiotherapy

Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline

“…The age of patients and life expectancy should be taken into account in the selection of radiotherapy with regard to rare but possible radiation-induced malignancies [68]. Tumours in poorly vascularised or easily traumatised areas, advanced lesions invading bones, joints or tendons and lesions in previously irradiated areas are contraindications for RT [65].…”

Radiation‐induced angiosarcoma of the breast: A review

“…RIAS may develop as soon as 6 months and as late as 41 years after radiotherapy (average latency of 6 years) . The latency of RIAS of the breast seems to be shorter when compared to radiation‐induced sarcomas in general, which take an average of 10‐12 years to develop after radiotherapy, and to AS associated with chronic lymphedema, which has a latency period of 10 years …”

“…On microscope, RIAS has similar morphological features as primary AS . Cutaneous AS is an invasive tumor with poorly defined borders, found in the dermis and often infiltrating the subcutis (Figure ). It is characterized by irregular, anastomosing vessels, lined by crowded swollen endothelial cells with a scarce cytoplasm, showing different degrees of nuclear atypia .…”

“…AVLs (also named atypical vascular proliferations, benign lymphangiomatous papules, lymphangioma circumscriptum , benign lymphangioendotheliomas, acquired progressive lymphangiomas, and acquired lymphangiectasis) have been classically included in the differential diagnosis of RIAS. They are histologically characterized by focal proliferation of dilated vascular channels lined by a single layer of endothelial cells in the dermis, and they can be distinguished from AS by the presence of circumscription, dermal location, associated chronic inflammation, projection of stroma into the lumen, the lack of malignant aspects (atypia, mitoses, papillary endothelial hyperplasia), and the absence of myc amplification . The etiology of the AVL is poorly understood, with some authors considering it a benign lesion and others a precursor lesion to AS …”

“…Angiosarcoma can affect several organs, but the skin is one of the most frequently affected . There are essentially three different clinical types of cutaneous AS: of the scalp and face of an elderly person (idiopathic), the most common form; chronic lymphedema‐associated AS (Stewart‐Treves syndrome); and radiation‐induced angiosarcoma (RIAS), the least common . This review will focus on RIAS (also termed post‐radiation AS or radiation‐associated AS), with emphasis on RIAS of the breast, which is the most common location of this condition.…”