Long-term toxic effects of radiations: sarcomatoid carcinoma and multiple basal cell carcinoma of the limbs in chronic radiodermatitis.

A 73-year-old woman was referred to our attention for the presence of severe chronic lymphoedema and neoplastic lesions of the limbs. When she was 19 years old, the patient had undergone X-ray epilation of the limbs to remove unwanted body hair. The neoplastic lesions, observed 2 years before our observation, were excised, and histological examination revealed multiple basal cell carcinomas and a spindle squamous cell carcinoma on the left thigh. The case we observed offers some interesting points of consideration as it shows that in nonexposed areas cutaneous carcinomas can appear many years after irradiation and that the same treatment consequently requires careful follow-up for life. Another point of interest is the particular hystological aspect of neoplastic lesions in the site of radiodermatitis that requires in-depth immunohistochemical investigation for an exact diagnosis. Patients with previous treatment with ionizing radiation also in nonexposed areas need lifelong follow-up to identify cutaneous tumors at an early treatable stage.