Medical Evidence: Several advisory opinions from medical experts were obtained by the Board as to whether basal cell carcinoma of the left arm and face was etiologically related to exposure to the sun and/or post-service X-ray therapy for bursitis of the left shoulder. These medical experts were generally in agreement that the X-ray therapy was not related to the skin tumors. One of the experts stated: CASE NO. 18 The X-ray therapy given this veteran appears to be small in amount, from the record, although exactfigures are not stated. This conclusion is confirmed by the appearance of skin, without atrophy, and absence of pathological changes in the skin such as telangiectases and vascular Type ofInjury: Carcinoma of the Left Arm and Face. BVA's Decision: Denial Reversed. Claim could not be supported on basis the carcinoma was caused by X-ray radiation but compensation granted on other grounds. damage. Consequently, it is so unlikely as to be unworthy of consideration that this dosage led to carcinoma formation. Moreover, carcinoma secondary to radiation is squamous, not basal type. Another expert, a radiologist, stated: Date of Decision: 1967. The question at issue in this case is whether the patient developed a radiation induced basal epithelioma in the left upper arm on thebasis of treatment by deep X-ray therapy of a benign condition of the shoulder nine years previously. I believe that the multiple basal cell epitheliomas of the face which developed cannot in any way be attributed to the roentgen treatment of the shoulder and, therefore, need not be further considered. The proper administration of X-ray therapy will have totally excluded the facial area Appellant's Allegation: That basal cell carcinomaof the face and left arm were due to either exposure to sun in service and/or post service X-ray therapy. Facts: Veteran’s active military service was from March 1941 to December 1945 including overseas duty in the Asiatic-Pacific Theater from February 1944 to September 1945. After basic training, specific assignments were a year as a light truck driver, 5 months as a lineman, !% years as a light artillery gun crewman, and 15 months as a tank commander. Veteran served with a cannon company of an infantry regiment during the Solomon Island and Philippine campaigns. In June 1945 he developed infectious hepatitis and was hospitalized until evacuation to the United States in November 1945. Following his return to the United States he was treated for pain in the region of his left shoulder. He was discharged from the service in 1945 because ofan arthritis involving the 4th and Sth lumbar vertebrae which was thought to be traumatic, resulting from a fall in March 1944. The !umbasacral spine was X-rayed in June, July, from the affect of the X-ray beam. It is, therefore, only a question of the single basal cell epithelioma of thearm. It is stated that the patient received six deep X-ray therapy treatments to the left shoulder in 1947. 1 do not have available the information as to the total dose received. I will assume that the treatment was directed by a properly trained radiotherapist and, therefore, that the total dose given the patient was the standard amount for treating a benign condition in this area and, therefore, well below the lesions were found at any time. Post-service treatment of service-connected bursitis of the left shoulder included two periods of deep X-ray therapy in 1947 and 1950. Between March 25 and April 5, 1947 six deep X-ray therapy treatments to the left shoulder were given. Dose and field were not recorded. Deep X-ray therapy to the left shoulder was also administered in December 1950 on eight occasions with a 200 kv machine. Exact fields were not recorded. Records indicated the dose as 105 r. It is not clear whether veteran received a total of 105 1 or 105 r for each treatment. Almost six years after the 1950 therapy, a basal cell epithelioma was found on the lateral aspect of the left arm. The same malignancy was discoverd shortly thereafter in an old scar on the cheek and subsequently appeared on the temples and right upperlip and cheek. He received X-ray treatment from August to October 1956. Ten X-ray treatments in all were given to the fingers; of these, eight were also directed to the arm. However the exact location and dose were not specified. Dental X-rays were made in December 1946, January 1948 and January 1950. 62 ee August and October 1945. No other X-rays in service are of record, and no skin amount likely to produce a radiation injury to the skin. There is no mention in the folder of an abnormal appearance of the skin in the area of treatment such as atrophy, depigmentation, telangiectases, or ulceration which would occur in an area of radiation dermatitis. It is not considered likely that a skin cancer would develop in a region where no apparent skin damage existed. Radiation carcinomas of the skin are knownto arise in areas heavily damaged by chronic radiation. Even in these cases there is usually a long period of time before the epithetioma develops. In this case only nine years have passed between the time of treatment and the date of removal of the epithelioma. This is considered too brief an interval for there to be a direct association between the two factors. In addition, if the point is considered relevant to this case, basal cell epitheliomas are relatively benign and with proper treatment do not recur. They only produce local growth and do not metastasize. Basal cell epitheliomas commonly occur in males in the later decades 63