Successful Radiotherapy in Management of Inoperable Trichoblastic Carcinoma: A Case Report.

Area of Science:

• Oncology
• Dermatology
• Radiation Oncology

Background:

• Trichoblastic carcinoma (TC) is a rare adnexal tumor often presenting on the scalp and face.
• TC's non-specific clinical presentation can mimic basal cell carcinoma (BCC).
• Optimal treatment and outcomes for TC are not well-established, especially for locally-advanced cases.

Purpose of the Study:

• To evaluate the efficacy of external beam radiation therapy (EBRT) as a conservative treatment for locally-advanced trichoblastic carcinoma.
• To present a case study of successful EBRT in an elderly, immunodeficient patient with unresectable TC.

Main Methods:

• A case report of an 86-year-old male with a locally-advanced nasal TC is presented.
• Intensity-modulated radiotherapy (IMRT) using tomotherapy was administered, delivering 70 Gy in 35 fractions over two months.
• A specialized bolus was used to ensure adequate skin dose delivery.

Main Results:

• The patient achieved complete remission with no residual lesion observed one month post-treatment.
• Complete remission was maintained for nine months of follow-up.
• Treatment resulted in manageable Grade 2 side effects including radiodermatitis, mucositis, and conjunctivitis.

Conclusions:

• External beam radiation therapy is a potentially effective and acceptable alternative treatment for unresectable trichoblastic carcinoma.
• This case highlights the successful application of EBRT in an elderly patient with significant comorbidities.
• Radiotherapy may be a valuable conservative option for TC, particularly when surgery is not feasible.