1. Helical tomotherapy for scalp recurrence of primary eccrine mucinous adenocarcinoma
- Author
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Lara Rigoni, Micaela Motta, A.M. Deli, Elena De Martin, Filippo Alongi, Riccardo Calandrino, Nadia Di Muzio, Claudio Landoni, E. Maggiulli, Claudio Fiorino, Sara Broggi, Motta, M, Alongi, F, De Martin, E, Fiorino, C, Maggiulli, E, Rigoni, L, Landoni, C, Broggi, S, Deli, Am, Calandrino, R, Di Muzio, N, and Deli, A
- Subjects
Cancer Research ,medicine.medical_treatment ,Planning target volume ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Mucinous ,Tomography ,Dose Fractionation ,MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,Radiation ,medicine.diagnostic_test ,Head and Neck Neoplasm ,General Medicine ,Adenocarcinoma, Mucinous ,X-Ray Computed ,medicine.anatomical_structure ,Oncology ,Local ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Adenocarcinoma ,Female ,Radiology ,Human ,Simultaneous integrated boost ,medicine.medical_specialty ,Tomotherapy ,03 medical and health sciences ,medicine ,Humans ,Adenocarcinoma, Mucinou ,Aged ,Dose Fractionation, Radiation ,Neoplasm Recurrence, Local ,Positron-Emission Tomography ,Salvage Therapy ,Scalp ,Sweat Gland Neoplasms ,Tomography, X-Ray Computed ,Tomography, Spiral Computed ,Dose delivery ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Surgery ,Neoplasm Recurrence ,Spiral Computed ,business - Abstract
Primary cutaneous mucinous carcinomas originating from sweat glands are rare tumors with patterns of spread that are difficult to predict. We present a case of a five times recurring eccrine mucinous adenocarcinoma of the scalp, previously treated with surgery and adjuvant radiation therapy. After magnetic resonance imaging (MRI) and 18F-fluoro-2-deoxyglucose positron-emission tomography/computed tomography (18FDG-PET/CT), which documented local recurrence, the patient was considered eligible for salvage irradiation of the scalp. We decided to use helical tomotherapy, which combines conformity of dose delivery with the possibility of daily control of the setup accuracy. Forty gray (2Gy/fraction) to the planning target volume and 50 Gy (2.5Gy/fraction) to the biological target volume defined on the basis of 18FDGPET/CT was prescribed with a simultaneous integrated boost technique. After 12 fractions the patient was submitted to intermediate evaluation by 18FDG-PET/CT, which showed a partial response to the treatment. After 2, 4, 8, and 12 months, 18FDG-PET/CT showed a complete metabolic local response. This experience suggests a possible role of 18FDG-PET/CT-guided helical tomotherapy as an alternative to repeated and frequently demolitive surgery approaches.