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Case Reports
. 2023 Jan 20:16:185-192.
doi: 10.2147/CCID.S398275. eCollection 2023.

Complete Remission of Vulvar Squamous Cell Carcinoma After Volumetric Modulated Arc Therapy in Copper Smelting and Purification Workers: A Case Report

Xiaoting Yang  1 , Mei Cai  1 , Nan Li  2
Affiliations
Case Reports

Complete Remission of Vulvar Squamous Cell Carcinoma After Volumetric Modulated Arc Therapy in Copper Smelting and Purification Workers: A Case Report

Xiaoting Yang et al. Clin Cosmet Investig Dermatol. .

Abstract

Vulvar squamous cell carcinoma (VSCC) is the most frequent vulvar neoplasia, with invasiveness and metastasis. Typically, surgery is the preferred treatment. Radiotherapy is commonly used for unresectable locally advanced tumors and for early-stage patients who are at risk of serious complications from surgery or have a severe concomitant disease that prevents them from undergoing surgery. Compared to external irradiation, three-dimensional conformal radiotherapy (3D-CRT), and intensity-modulated radiotherapy (IMRT), various studies using volumetric modulated arc therapy (VMAT) alone in early-stage VSCC have been reported rarely. In this case, the patient had a large skin lesion and no lymph node metastasis. Surgical excision would seriously affect the urinary function and vulvar shape, so radical radiotherapy was given. To ensure the radiation dose for the radical treatment effect and to avoid high-dose radiation to normal organs, the volumetric intensity-modulated radiotherapy technique was chosen. After treatment, the patient's vulvar appearance returned to normal, and the tumor achieved complete remission without further surgery or chemotherapy, with no local recurrence or associated toxic side effects. This suggests that the efficacy of VMAT alone in early-stage VSCC is accurate and worthy of clinical promotion. The patient had been engaged in copper smelting and purification for many years, and it is unusual for her to have skin lesions with such a large surface area. In conjunction with her previous history of nasal basal cell carcinoma, the mechanism of oxidative stress during metal exposure should be further clinically examined, as it may be crucial in the formation and progression of malignancies.

Keywords: metal; oxidative stress; radiotherapy; skin malignancies; squamous cell carcinoma.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Clinical photographs prior to treatment.
Figure 2
Figure 2
(A and B) Basophilic cell-forming tumor masses can be seen, with dense cellular arrangements and a lack of the classic fenestrated arrangement around them. (Hematoxylin and eosin;×20).
Figure 3
Figure 3
(A) Ki-67(+), (B) P16(+). (Immunohistochemical staining;×20).
Figure 4
Figure 4
Pathology sampling biopsy three months after the end of treatment.(Hematoxylin and eosin;×20).
Figure 5
Figure 5
(A)Just after the VMAT, (B) three months after completion of treatment, (C) six months after completion of treatment.
See this image and copyright information in PMC

References

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