E Sattler1, H-C Räwer, M Mühlstädt, T Ruzicka, W Burgdorf, C Kunte. 1. Klinik und Poliklinik für Dermatologie und Venerologie, Ludwig-Maximilans-Universität, Frauenlobstr. 9-11, 80337, München, Deutschland. elke.sattler@med.uni-muenchen.de
Abstract
BACKGROUND: Early treatment of port wine stains with ionizing radiation can lead to the development of often multifocal basal cell carcinomas (BCC) after decades. In most cases it is clinically impossible to distinguish between the tumor and the underlying vascular malformation and to decide where to set surgical margins. PATIENTS AND METHODS: We report on a series of three patients with BCC overlying a port wine stain that had previously been treated with radiation therapy in early childhood. In all patients Mohs surgery was performed to insure complete excision of the BCC. RESULTS: In our patients, development of BCC occurred about 20 to 40 years after radiation therapy. Clinically - without the help of Mohs surgery - the borders of the BCC could not have been detected due to the underlying nevi flammei in all cases. CONCLUSIONS: BCC overlying a port wine stain previously treated with radiation therapy is a rare but ideal indication for Mohs surgery. In addition we recommend regular clinical follow-ups to detect recurrent or additional BCC as early as possible.
BACKGROUND: Early treatment of port wine stains with ionizing radiation can lead to the development of often multifocal basal cell carcinomas (BCC) after decades. In most cases it is clinically impossible to distinguish between the tumor and the underlying vascular malformation and to decide where to set surgical margins. PATIENTS AND METHODS: We report on a series of three patients with BCC overlying a port wine stain that had previously been treated with radiation therapy in early childhood. In all patients Mohs surgery was performed to insure complete excision of the BCC. RESULTS: In our patients, development of BCC occurred about 20 to 40 years after radiation therapy. Clinically - without the help of Mohs surgery - the borders of the BCC could not have been detected due to the underlying nevi flammei in all cases. CONCLUSIONS: BCC overlying a port wine stain previously treated with radiation therapy is a rare but ideal indication for Mohs surgery. In addition we recommend regular clinical follow-ups to detect recurrent or additional BCC as early as possible.
Authors: Joshua A Tournas; Jennifer Lai; Anne Truitt; Y C Huang; Kathryn E Osann; Bernard Choi; Kristen M Kelly Journal: Photodiagnosis Photodyn Ther Date: 2009-11-12 Impact factor: 3.631