High-Dose Epidermal Radionuclide Therapy with 188 Re (Rhenium) Resin in a Patient with Multiple Actinic Keratoses

Abstract Aim  High-dose epidermal radionuclide therapy using a nonsealed 188 Re (Rhenium) resin is an alternative treatment option for nonmelanoma skin cancer. In this case study, we present the possible use of this therapy in a patient with multiple actinic keratosis (AK), which is a precancer of the skin. Methods  A 55-year-old male was presented in our department with multiple AK, located on the cheek, temporal, and frontal area, with 1, 1, 2.1, and 2.5 cm 2 surface. Applied activity was 80, 80, 167, and 168 MBq 188 Re with a target absorbed dose for each lesion 35 Gy at 1 mm. The treatment was well tolerated. Results  At 17 months’ follow-up, all treated area showed complete remission. There were no side effects, except mild focal hypopigmentation. Conclusion  This case demonstrates the high potential of epidermal radionuclide therapy with a nonsealed 188 Re as a noninvasive, effective, and well-tolerated therapy option for patients with multiple AK, when surgery is difficult to perform or not recommended of other reasons.