Basal cell carcinoma and World War II–era cathode ray oscilloscope exposure

Basal cell carcinoma arising over facial port wine stain: a single-centre experience

BACKGROUND

A growing number of reports point to a possible connection between basal cell carcinoma (BCC) and port wine stain (PWS). Researchers suggest that either the elevated temperature induced by the increased dermal vasculature or an oncogenic factor produced by the ectatic vessels makes the overlying epidermis more susceptible to ultraviolet or ionizing radiation.

OBJECTIVE

To check the prevalence of BCC in patients with PWS at a large national vascular amomalies centre.

METHODS

The study group included 68 patients, 44 women and 24 men, with facial PWSs. Detailed data were collected on background features, past treatments and past exposure to radiation, and a comprehensive physical examination was performed. Biopsy samples were taken from suspect lesions for histological study.

RESULTS

Four patients (5.9%) were found to have histologically proven BCC, 3 nodular and one multifocal. All had been exposed to radiation during childhood. Treatment consisted of excision; there was one recurrence.

CONCLUSION

Although the co-occurrence of BCC and PWS is probably related to radiation treatment in childhood, these findings should alert physicians to regularly examine PWSs for cancerous changes, especially in patients at risk.

Marjolin's ulcer revisited--basal cell carcinoma arising from grenade fragments? Case report and review of the literature

BACKGROUND

Marjolin's ulcer is a rare and often aggressive cutaneous malignancy arising in previously traumatized or chronically inflamed skin.

METHOD

CASE REPORT

A 79-year-old World War II veteran developed basal cell carcinoma (BCC) at the site of a war wound. The tumour developed in relation to several metal grenade fragments. With a disease-free interval of 61 years between injury and onset of complications the patient had one of the longest latency periods of tumour development described so far.

RESULTS

Review of the literature reveals only five cases of relation between grenade fragments and malignancy formation. Presence of foreign bodies has been described as possible aetiology for malignancy development. Explosives and additives contain several mutagenic and tumourigenic substances. We hypothesize a causal connection between the grenade fragments and the development of BCC. Considering the long period of latency between injury and tumour development we suggest grenade injury with left fragments in soft tissue to be a new origin of Marjolin's ulcer.