Radiotherapy for giant squamous cell carcinomas

45 Correspondence Radiotherapy for giant squamous cell carcinomas A 90-year-old man presented with three cutaneous nodules on his forehead. Physical examination revealed a 7 × 7-cm keratotic nodule covered with a hematic, purulent exudate on the right temple, and two keratotic nodules in the middle of the forehead, measuring 7 × 5 cm and 6 × 3 cm, respectively (Fig. 1). The case history revealed that the patient lived in difficult socio-economic conditions following his wife’s death, and could not say when the nodules had first appeared. Incisional biopsies were performed on all lesions, with histologic examination revealing squamous cell carcinoma. A sonogram of the neck lymph nodes was negative. All three squamous cell lesions were treated with radiotherapy, with irradiation fields encompassing skin margins of 1 cm around each one. The total dose administered to each lesion was 30 Gy, subdivided into six sittings. Complete remission was obtained with acceptable aesthetic results: mild skin atrophy (Fig. 2). Eighteen months after treatment, there are no signs of relapse. The follow-up planned is every 6 months for 5 years and then annually.