Chernobyl’s Aftermath: Multiple Manifestations of Basalioma in a Patient after Radioactive Contamination in 1986

Abstract

Background: The Chernobyl nuclear disaster is still considered the worst nuclear accident in history. The particles were dispersed over the former USSR and large parts of Western Europe, leading to radioactive exposure to more than 10 million people. Radioactivity is a risk factor for the development of basal cell carcinoma (BCC), since radiation-induced mutations in both Sonic hedgehog (Shh) signaling pathway genes and TP53 have been described. Methods: We present the case of a patient with a history of radiation exposure following the 1986 Chernobyl accident who presented to our outpatient clinic with recurrent basal cell carcinoma in the facial region. Case: The patient presented to our clinic with two facial lesions suspicious for BCC. Although there were no typical risk factors, 11 BCCs had previously been removed. The patient had been building shelters for the construction workers working on the sarcophagus around the destroyed reactor immediately after the 1986 accident. Staging using an 18F-FDG-PET/CT as well as ultrasound of the abdomen revealed no other tumor manifestations. Diagnostic excision of the two facial lesions was performed, and a histopathological workup revealed BCC at the right temporal region and acanthopapillomatosis with no sign of malignancy at the corner of the mouth. After presentation to the tumor board, complete resection of the BCC was initiated. Conclusions: This case demonstrates the value of early use of 18F-FDG-PET/CT in staging/restaging to visualize BCC location, local spread and potential metastases or secondary tumors and to aid in the decision for therapeutic management.