A case of Bowen"s disease responding well to radiotherapy

Year 2013, Volume: 38 Issue: 4, 813 - 817, 01.12.2013

Göknur Kalkan Günseli Şefika Pancar

Abstract

Bowen"s disease is a form of intraepidermal squamous cell carcinoma which is known as carsinoma in situ. The head, neck, and extremities are the most commonly affected anatomic locations. Treatment options for Bowen"s disease include observation, surgery, cryotherapy, electrodesiccation and curettage, topical application of 5-fluorouracil or imiquimod, Moh"s micrographic surgery, photodynamic therapy, and radiotherapy. Radiation therapy is advantageous in patients who refuse surgery, for large or multiple lesions, for lesions in cosmetically sensitive areas, and in patients who are predisposed to formation of keloids, with a high cure rate cited in the literature. Here we report a 70-year-old man who was diagnosed as Bowen"s disease and completely healed with the treatment of radiotherapy. By means of this case report, we will review the current literature and empasize that radiotherapy is an effective treatment alternative for Bowen's disease in the suitable lesions.

Keywords

Bowen"s disease, radiotherapy, squamous cell carcinoma

Radyoterapi iyi yanıt veren Bowen hastalığı olgusu

Abstract

Bowen hastalığı karsinoma insitu olarak bilinen intraepidermal yassı hücreli karsinom türüdür. En sık yerleşim alanları ise baş-boyun, ekstremiteler ve gövde olarak sıralanmaktadır. Tedavisinde takip ve gözlem, cerrahi eksizyon, kriyoterapi, koterizasyon ve küretaj, Mohs mikroskobik cerrahisi, fotodinamik tedavi, lazer ablasyon, 5-FU, imiquimod ve radyoterapi yer almaktadır. Radyoterapi, cerrahiyi reddeden, geniş veya çoklu lezyonları olanlarda, kozmetik olarak hassas alanlarda ve keloid oluşumuna yatkın olanlarda oldukça avantajlı olarak bildirilmiştir ve literatürde yüksek kür oranları ile desteklenmiştir. Burada sağ el 3. parmağındaki lezyon için Bowen hastalığı tanısı alan ve lezyonunun radyoterapi ile tamamen düzelme gösterdiği 70 yaşında erkek hasta sunulmaktadır. Bu olgudan hareketle Bowen hastalığında radyoterapi tedavisine ait literatür bilgileri tekrar gözden geçirilecek ve radyoterapinin bu hastalıkta uygun lezyonlarda etkili bir tedavi seçeneği olduğu vurgulanacaktır.

Keywords

Bowen hastalığı, radyoterapi, yassı hücreli karsinom

References

• Kossard S, Rosen R. Cutaneous Bowen's disease. An analysis of 1001 cases according to age, sex, and site. J Am Acad Dermatol. 1992; 27:406-10.
• Reizner GT, Chuang TY, Elpern DJ, Stone JL, Farmer ER. Bowen's disease (squamous cell carcinoma in situ) in Kauai, Hawaii. A populationbased incidence report. J Am Acad Dermatol. 1994; 31:596-600.
• Cox N, Eedy DJ and Morton CA. Guidelines for management of Bowen’s disease, British J Dermatol. 1999; 141: 633-641.
• Dupree MT, Kiteley RA, Weismantle K, Panos R, Johnstone PA. Radiation therapy for Bowen’s disease: Lessons for lesions of the lower extremity. J Am Acad Dermatol. 2001; 45: 401-4.
• Cox NH, Dyson P. Wound healing on the lower leg after radiotherapy or cryotherapy of Bowen’s disease and other malignant skin lesions. Br J Dermatol. 1995; 133: 60-5.
• Caccialanza M, Piccinno R, Beretta M, Gnecchi L. Results and side effects of dermatologic radiotherapy: A retrospective study of irradiated cutaneous epithelial neoplasms. J Am Acad Dermatol. 1999; 41: 589-94.
• Lukas VanderSpek LA, Pond GR, Wells W, Tsang RW. Radiation therapy for Bowen's disease of the skin.Int J Radiat Oncol Biol Phys. 2005; 63:505-10.
• Herman JM, Pierce LJ, Sandler HM Griffith KA, Jabbari S, Hiniker SM, et al. Radiotherapy using a water bath in the treatment of Bowen's disease of the digit. Radiother Oncol. 2008; 88:398-402.
• Papillon J, Chassard JL. Respective roles of radiotherapy and surgery in the management of epidermoid carcinoma of the anal margin. Dis Colon Rectum. 1992; 35: 422-9.
• McKenna DJ, Morris S, Kurwa H. Treatmentresistant giant unilateral Bowen's disease of the scalp responding to radiotherapy. Clin Exp Dermatol. 2009; 34:85Anna Z, John K, Maria T, George K, Ivelina B, Ioanna K, et al. The potential role of radiation therapy in Bowen's disease: a review of the current literature. Rev Recent Clin Trials. 2012; 7: 42-6.
• Yazışma Adresi / Address for Correspondence: Dr. Göknur Kalkan Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dermatoloji Anabilim Dalı 60100 TOKAT e-mail: [e-mail] geliş tarihi/received :24.09.2012 kabul tarihi/accepted:07.12.2012