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June 1986

Invasive Basal Cell Carcinoma After Repeated Diagnostic Fluoroscopic Examinations

Author Affiliations

Department of Dermatology Dalhousie University Halifax, Nova Scotia, Canada B3H 1Z4

Arch Dermatol. 1986;122(6):628-629. doi:10.1001/archderm.1986.01660180028007

To the Editor.—  Multiple fluoroscopic examinations are well known to be associated with an increased rate of neoplasia in irradiated tissue. These examinations have been largely abandoned for 30 years, but cases of skin carcinoma are still appearing after such exposure during the 1940s and 1950s. We report a case of an unusually invasive basal cell carcinoma in a patient with prior multiple fluoroscopic examinations.

Report of a Case.—  In 1984, a 69-year-old man presented with a five-year history of a progressively enlarging, asymptomatic lesion on the anterior central chest. There was no history of preexisting skin change or scarring in this area. From 1947 through 1950, the patient had undergone numerous fluoroscopic examinations as part of artificial pneumothorax therapy for tuberculosis. There was no history of arsenic ingestion.Examination revealed a 10 × 14-cm plaque overlying the sternum with a black serpiginous elevated border. There was central ulceration with