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Case Report/Case Series
September 2015

Local Recurrence and Ocular Adnexal Complications Following Electronic Surface Brachytherapy for Basal Cell Carcinoma of the Lower Eyelid

Author Affiliations
  • 1AO Surgical Arts, Salt Lake City, Utah
  • 2Huntsman Cancer Institute, Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City
  • 3Huntsman Cancer Institute, Department of Dermatology, University of Utah School of Medicine, Salt Lake City
JAMA Dermatol. 2015;151(9):1002-1004. doi:10.1001/jamadermatol.2015.2613

Importance  Various treatment options exist for nonmelanoma skin cancer (NMSC), including topical agents, surgery, or definitive or adjuvant radiation therapy. Recently, electronic surface brachytherapy (ESB) has been described as a noninvasive option for NMSC. We report a case of local recurrence of basal cell carcinoma (BCC) and ocular complications following ESB to the lower eyelid.

Observations  A man in his 60s presented with a recurrent BCC within the radiation field 10 months after undergoing ESB for a biopsy-proven BCC. In addition to the recurrence, he had contracture of the conjunctiva in the socket of his previously enucleated eye, as well as lower eyelid ectropion, resulting in displacement and loss of retention of his ocular prosthesis.

Conclusions and Relevance  Electronic surface brachytherapy should be used with caution, particularly in the periocular region because the late effects of hypofractionated radiation may cause ocular and orbital complications. To our knowledge, this is the first reported case of ocular complications with this modality. This case highlights a local recurrence following use of this new treatment modality, suggesting further investigation is warranted to determine the safety and efficacy of ESB.