The Controversial Late Effect of Shoulder Radiation Therapy in a Small Case Series.

Abstract

Introduction: Radiodermatitis is a common complication experienced by patients undergoing radiation therapy. Its severity can vary from mild erythema to more serious conditions, including desquamation, ulceration, and, in extreme cases, necrosis. In addition, it is widely acknowledged that radiotherapy (RT) itself carries oncogenic risks, potentially causing cellular mutations that may lead to the development of neoplasms, sometimes years after treatment. Diagnostic and staging tools such as magnetic resonance imaging, computed tomography, and positron emission tomography scans are crucial in these cases, with biopsy serving as the definitive method for histological confirmation. However, large excisions often required in these situations necessitate complex reconstructive procedures and are associated with a high risk of local complications, including wound dehiscence and infection.

Case report: We present three cases of radiodermatitis that developed following radiation therapy to the shoulder. These cases highlight the need to consider radiodermatitis as a differential diagnosis for skin changes occurring after RT, especially in patients with a history of cancer.

Conclusion: The misdiagnosis or delayed diagnosis of radiodermatitis can substantially increase patient morbidity. Greater awareness of this potential complication underscores the importance of closely monitoring for skin-related issues in patients receiving RT.