Radyoterapi iyi yanıt veren Bowen hastalığı olgusu

Bowen hastalığı karsinoma insitu olarak bilinen intraepidermal yassı hücreli karsinom türüdür. En sık yerleşim alanları ise baş-boyun, ekstremiteler ve gövde olarak sıralanmaktadır. Tedavisinde takip ve gözlem, cerrahi eksizyon, kriyoterapi, koterizasyon ve küretaj, Mohs mikroskobik cerrahisi, fotodinamik tedavi, lazer ablasyon, 5-FU, imiquimod ve radyoterapi yer almaktadır. Radyoterapi, cerrahiyi reddeden, geniş veya çoklu lezyonları olanlarda, kozmetik olarak hassas alanlarda ve keloid oluşumuna yatkın olanlarda oldukça avantajlı olarak bildirilmiştir ve literatürde yüksek kür oranları ile desteklenmiştir. Burada sağ el 3. parmağındaki lezyon için Bowen hastalığı tanısı alan ve lezyonunun radyoterapi ile tamamen düzelme gösterdiği 70 yaşında erkek hasta sunulmaktadır. Bu olgudan hareketle Bowen hastalığında radyoterapi tedavisine ait literatür bilgileri tekrar gözden geçirilecek ve radyoterapinin bu hastalıkta uygun lezyonlarda etkili bir tedavi seçeneği olduğu vurgulanacaktır.

Anahtar Kelimeler:

Bowen hastalığı, radyoterapi, yassı hücreli karsinom

A case of Bowen"s disease responding well to radiotherapy

Bowen"s disease is a form of intraepidermal squamous cell carcinoma which is known as carsinoma in situ. The head, neck, and extremities are the most commonly affected anatomic locations. Treatment options for Bowen"s disease include observation, surgery, cryotherapy, electrodesiccation and curettage, topical application of 5-fluorouracil or imiquimod, Moh"s micrographic surgery, photodynamic therapy, and radiotherapy. Radiation therapy is advantageous in patients who refuse surgery, for large or multiple lesions, for lesions in cosmetically sensitive areas, and in patients who are predisposed to formation of keloids, with a high cure rate cited in the literature. Here we report a 70-year-old man who was diagnosed as Bowen"s disease and completely healed with the treatment of radiotherapy. By means of this case report, we will review the current literature and empasize that radiotherapy is an effective treatment alternative for Bowen's disease in the suitable lesions.

Keywords:

Bowen"s disease, radiotherapy, squamous cell carcinoma,

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Yazışma Adresi / Address for Correspondence: Dr. Göknur Kalkan Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dermatoloji Anabilim Dalı 60100 TOKAT e-mail: goknurkalkan@yahoo.com geliş tarihi/received :24.09.2012 kabul tarihi/accepted:07.12.2012