Basal Cell Carcinoma of the Head With Intense [ 68 Ga]OncoFAP Uptake

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Basal cell carcinoma (BCC) can become locally invasive and treatment-resistant.
• Advanced BCC poses diagnostic challenges, especially with metallic implants precluding MRI.
• Previous imaging modalities like CT may be limited in assessing tumor viability after radiation.

Purpose of the Study:

• To evaluate the utility of 68Ga-OncoFAP PET/CT in a patient with advanced, treatment-refractory basal cell carcinoma.
• To assess fibroblast activation protein (FAP) expression in a rare case of advanced and metastasized BCC.
• To explore 68Ga-OncoFAP PET/CT as a potential tool for guiding stereotactic body radiation therapy in challenging BCC cases.

Main Methods:

• Case presentation of a 72-year-old male with advanced, locally invasive basal cell carcinoma.
• Utilized 68Ga-OncoFAP PET/CT for tumor imaging due to limitations of MRI and CT.
• Considered stereotactic body radiation therapy based on PET/CT findings.

Main Results:

• The patient had failed multiple prior treatments including surgery and radiation.
• MRI was not feasible due to facial implants.
• CT scans were inconclusive for vital tumor assessment due to slow progression and prior radiation.
• 68Ga-OncoFAP PET/CT demonstrated vigorous fibroblast activation protein (FAP) expression, indicating potential for targeted therapy.

Conclusions:

• 68Ga-OncoFAP PET/CT can be a valuable tool for evaluating advanced basal cell carcinoma, particularly when other imaging methods are limited.
• Vigorous FAP expression in advanced BCC suggests potential for targeted therapies.
• This case underscores the importance of novel imaging in managing complex oncological cases.