Squamous Cell Carcinoma – 70 Years after Irradiation

Abstract

The rare event of invasive squamous cell carcinoma 70 years after irradiation to the scalp for tinea capitis, occurred in a 75-year-old Caucasian male. The clinical, histological, roentgenologic and magnetic resonance imaging picture are described, and the literature is reviewed.

Squamous Cell Carcinoma of the Scalp After Radiotherapy for Tinea Capitis

“…One case report described a man who suffered from alopecia after having been irradiated at the age of 5 years; a squamous cell carcinoma of the scalp developed 70 years later. 8 Our patient had similar findings to the subset of patients with radiodermatitis, although her scalp was never exposed to the sun. She began wearing a wig immediately after developing alopecia and almost never removed it: Neither her husband of 50 years nor her son has seen her without a wig.…”

“…3 Despite relatively low radiation doses, there have been reports of squamous cell carcinomas arising in the head and neck of a small number of adult patients who had received radiotherapy for tinea capitis in childhood. 1,[4][5][6][7][8] It has been difficult to distinguish the contribution of sun exposure from radiotherapy in these patients.…”

Radiation-Induced Angiosarcomas

“…Interestingly, this patient, as most women developing AS in the field of an irradiated breast, had no evidence of concurrent lymphoedema, strengthening the role of ionising radiation in the development of this neoplasm [4]. Although the appearance of malignant tumours caused by ionising radiation is a well-known phenomenon that may occur in the setting of radiotherapy [5,6], the incidence of radiotherapy-induced AS is low. Most frequent cutaneous tumours occurring after ionising radiation are basal cell and squamous cell carcinomas [5,6].…”

“…Although the appearance of malignant tumours caused by ionising radiation is a well-known phenomenon that may occur in the setting of radiotherapy [5,6], the incidence of radiotherapy-induced AS is low. Most frequent cutaneous tumours occurring after ionising radiation are basal cell and squamous cell carcinomas [5,6]. These cancers are also those for which the relation with chronic exposure of the skin to solar ultraviolet (UV) radiation is the best established.…”