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Montgomery C, Park KJ, Gardner JM, Majors I, Nicholas R. Post-Traumatic Sarcomas: Do They Exist? Int J Surg Pathol 2019; 27:722-728. [PMID: 31208254 DOI: 10.1177/1066896919848495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients often cite a history of trauma prior to the diagnosis of a sarcoma. Sparse literature suggests that there may be a link between sarcoma development and trauma. A 10-year review of academic tertiary-referral sarcoma center database was examined to identify patients who developed a sarcoma after having a history of a significant musculoskeletal trauma. A total of 501 patients were treated for a sarcoma during this time period. Six patients were identified as previously having a significant musculoskeletal trauma at the site of sarcoma development. Half of the sarcomas arose in bone and the other half in soft tissue. Five (83%) patients had multiple operations for the injury with 3 (50%) patients having a postoperative wound infection. The average time from injury to development of the sarcoma was 19.8 years. Survival after diagnosis was poor, and 4 (67%) of the patients died due to their metastatic disease within 3 years of diagnosis. Our findings suggest the possibility of post-traumatic sarcomas.
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Affiliation(s)
- Corey Montgomery
- 1 University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Kwan J Park
- 1 University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jerad M Gardner
- 1 University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Issac Majors
- 1 University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Richard Nicholas
- 1 University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Thomas J, Sravya I, Sreekumar NC, Nayal B. Rare leiomyosarcoma in a burn scar. INDIAN JOURNAL OF BURNS 2019. [DOI: 10.4103/ijb.ijb_9_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hmida L, Letaief F, Doghri R, Meddeb K, Mahjoubi K, Mokrani A, Yahiaoui Y, Gabsi A, Cheraiet N, Rais H, Ayadi M, Mezlini A. Cutaneous leiomyosarcoma on the trunk: An unusual presentation with an aggressive course - Case report and review of literature. Pan Afr Med J 2018; 31:190. [PMID: 31068995 PMCID: PMC6492208 DOI: 10.11604/pamj.2018.31.190.16682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 10/30/2018] [Indexed: 11/25/2022] Open
Abstract
Primary cutaneous leiomyosarcoma (PCL) are soft-tissue sarcoma, arising in the dermis, with or without extension into the subcutis. They are thought to have an indolent course compared to their subcutaneous counterparts, they may recur but rarely metastases. We report the case of a patient with a PCL arising in the anterior trunk wall who developed pulmonary, bone and retroperitoneal metastases 6 years after wide surgical excision of the primary tumor.
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Affiliation(s)
- Lina Hmida
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Feryel Letaief
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Raoudha Doghri
- Anatomic Pathology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Khedija Meddeb
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Khalil Mahjoubi
- Radiotherapy Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Amina Mokrani
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Yosra Yahiaoui
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Azza Gabsi
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Nesrine Cheraiet
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Henda Rais
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Mouna Ayadi
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
| | - Amel Mezlini
- Medical Oncology Department, Salah Azaiez Institute, Tunis, Tunisie
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Lee HW, Jeong YI, Suh HS, Lee MW, Choi JH, Moon KC, Koh JK. Two Cases of Dystrophic Calcinosis Cutis in Burn Scars. J Dermatol 2014; 32:282-5. [PMID: 15863851 DOI: 10.1111/j.1346-8138.2005.tb00763.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2004] [Accepted: 11/04/2004] [Indexed: 11/28/2022]
Abstract
Dystrophic calcinosis cutis is defined as the abnormal deposition of insoluble calcium salts in dead or degenerated cutaneous tissues in the absence of abnormal serum calcium or phosphate concentrations. Although dystrophic calcification can occur in various diseases, its occurrence on a burn scar has rarely been reported in the dermatologic literature. Herein we describe two patients who presented with a solitary non-healing ulcer in a postburn scar, with histopathologic evidence of calcium deposition in the dermis.
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Affiliation(s)
- Hae Woong Lee
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul 138-736, Korea
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Pol RA, Dannenberg H, Robertus JL, van Ginkel RJ. Cutaneous leiomyosarcoma arising in a smallpox scar. World J Surg Oncol 2012; 10:148. [PMID: 22799750 PMCID: PMC3436778 DOI: 10.1186/1477-7819-10-148] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 07/16/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2-3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. CASE PRESENTATION A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months' review the patient was doing well with no evidence of tumour recurrence. CONCLUSIONS This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.
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Affiliation(s)
- Robert A Pol
- Department of Surgery, University Medical Center Groningen, P,O, Box 30 001, Groningen RB 9700, The Netherlands.
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Mello DF, Carneiro S, Gonçalves KC, Jorge D. Burn scar pleomorphic sarcoma—case report. EUROPEAN JOURNAL OF PLASTIC SURGERY 2011. [DOI: 10.1007/s00238-011-0598-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lloyd M, Lyons I, Deodhar A, Flemming AS. Dermatofibrosarcoma protuberans arising in a bacillus Calmette-Guerin vaccination scar. EUROPEAN JOURNAL OF PLASTIC SURGERY 2008. [DOI: 10.1007/s00238-008-0267-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kowal-Vern A, Criswell BK. Burn scar neoplasms: a literature review and statistical analysis. Burns 2005; 31:403-13. [PMID: 15896501 DOI: 10.1016/j.burns.2005.02.015] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Accepted: 02/21/2005] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although squamous cell carcinoma (SCC) is the most common burn scar neoplasm, other neoplasms have also been reported. OBJECTIVE To compile the burn scar neoplasm cases in the literature and to analyze their frequency and demographic characteristics. MATERIALS AND METHODS Cases were obtained through literature searches. RESULTS There were 412 cases gleaned from 146 articles between 1923 and 2004. Seventy-one percent (293) of the tumors were squamous cell carcinoma, 12% (48) were basal cell carcinoma (BCC), 6% (23) were melanoma, 5% (21) were sarcoma, 4% (16) were other neoplasms, 1% (6) were squamo-basal cell carcinoma, and 1% (5) squamous cell-melanoma. The mean age at tumor diagnosis was 50 years, the mean age at the time of burn injury was 20 years, the mean latency interval was 31 years. Only 5% of the reported cases were excised and grafted at the time of injury (p<0.001). BCC occurred at a significantly later age compared to SCC and sarcoma groups (p<0.02) and had a shorter latency period compared to SCC and sarcoma groups (p<0.004) and melanoma (p<0.008). Local recurrence was present in 16% of the cases, while regional lymph node involvement was seen in 22% of the cases and distant metastases was present in 14% of the patients. The mortality rate was 21%. CONCLUSIONS Although the main burn scar neoplasm was SCC, other neoplasms contributed to the morbidity and mortality of burn patients. Excision and grafting of deep burns, and close follow-up of non-healing ulcerated burn scars is essential for the prevention and early detection of burn scar neoplasms.
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Affiliation(s)
- Areta Kowal-Vern
- Sumner L. Koch Burn Center, Department of Trauma, John H. Stroger, Jr. Hospital of Cook County, 1901 West Harrison Street, Room 3229, Chicago, IL 60612, USA.
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Tanaka A, Hatoko M, Tada H, Kuwahara M, Iioka H, Niitsuma K. Dermatofibrosarcoma protuberans arising from a burn scar of the axilla. Ann Plast Surg 2004; 52:423-5. [PMID: 15084891 DOI: 10.1097/01.sap.0000100421.95683.9b] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
It is well-known that the development of a malignant tumor in a chronic burn scar is one of the long-term complications of a severe burn. Most of these tumors are squamous cell carcinomas, and sarcomas are much rarely seen in chronic burn scars. In the previous literature, 24 cases of burn scar sarcomas were reported. The authors report the second case of dermatofibrosarcoma protuberans arising in a chronic, severe burn scar. A 68-year-old woman with a reddish tumor in the right axilla was referred to the authors' hospital. The patient had sustained severe burns in the right axilla, upper arm, and trunk at the age of 6 years. A biopsy specimen revealed dermatofibrosarcoma protuberans. There was no evidence of distant metastasis. The tumor was excised widely to include the surrounding burn scar. Two years after the operation, there was no evidence of tumor recurrence. As surgeons, we should recognize the possibility of the occurrence of various malignant tumors including sarcomas on burn scars.
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Affiliation(s)
- Aya Tanaka
- Division of Plastic Surgery, Nara Medical University, Kashihara, Nara, Japan.
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Green JJ, Heymann WR. Dermatofibrosarcoma protuberans occurring in a smallpox vaccination scar. J Am Acad Dermatol 2003; 48:S54-5. [PMID: 12734474 DOI: 10.1067/mjd.2003.168] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive, rarely metastatic, spindle cell tumor. Trauma has been associated with its development. Since the 1940s, malignant tumors have been described to occur in sites of smallpox vaccination scars. Five cases in the literature document DFSP arising in sites of prior immunizations. We report a case of DFSP occurring in a smallpox vaccination scar and review the available literature.
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Affiliation(s)
- Justin J Green
- Division of Dermatology, Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden, USA
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11
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O'Toole D, Fox JD. Chronic hyperplastic and neoplastic cutaneous lesions (Marjolin's ulcer) in hot-brand sites in adult beef cattle. J Vet Diagn Invest 2003; 15:64-7. [PMID: 12580300 DOI: 10.1177/104063870301500115] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Linear exophytic cutaneous lesions (brand keratomas) are a chronic sequel to hot-iron branding in a small proportion of beef cattle in the western United States. Rarely, brand keratomas progress to form large ulcerated masses. Samples of chronically thickened skin were collected from 8 adult cattle with hot-brand lesions and from 2 cattle with ulcerated masses at brand sites. Cutaneous thickening was attributable to abrupt transition from normal haired skin to regular epidermal hyperplasia with marked orthokeratotic hyperkeratosis, acanthosis, hypopigmentation, and loss of adnexae. Epithelial atypia was absent. Normal dermal collagen was replaced by mature granulation tissue containing islands of dense hyalinized collagen. Two cows, aged 5 and 13 years, developed large, slow-growing squamous cell carcinomas at brand sites. Malignancy in branded skin is a rare complication of hot-iron branding in cattle and may arise because of malignant transformation of brand keratomas.
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Affiliation(s)
- D O'Toole
- Wyoming State Veterinary Laboratory, University of Wyoming, Laramie, WY 82070, USA
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Abstract
The reported frequency of lung cancer in the setting of diffuse pulmonary fibrosis varies greatly, depending on the country of origin and the type of study. Most recent reports regarding diffuse pulmonary fibrosis in general and idiopathic pulmonary fibrosis in particular and lung cancers come from Japan; only a few clinical studies of this issue are available from other countries of the world, including the United States. The reported frequency ranges from 4.8% in the United States to 48.2% in Japan. The most frequent type of cancer is adenocarcinoma. Risk factors may include cigarette smoking, exposure to metal dusts, onset of idiopathic pulmonary fibrosis at an older age, and male predominance. Possible pathologic mechanisms are summarized. Given the very poor prognosis of idiopathic pulmonary fibrosis itself, with a mean survival of only 2.8 years, and that different diagnostic criteria were used in each study, it is likely that many of these studies are flawed because they evaluate lesions other than idiopathic pulmonary fibrosis. Thus, the frequency of lung cancer in idiopathic pulmonary fibrosis is still uncertain, and clearly requires follow-up of cohorts of clinically well-characterized patients, using standard diagnostic criteria for idiopathic pulmonary fibrosis. Finally, if the association between idiopathic pulmonary fibrosis and lung cancer is reconfirmed in these studies, the molecular and genetic mechanisms governing the development of lung cancer in this setting require additional study.
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Affiliation(s)
- Y Ma
- Department of Pathology, University of Southern California School of Medicine, Hoffman Medical Research Building Rm. 209, Los Angeles, CA 90033, USA.
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Ryan KL, D'Andrea JA, Jauchem JR, Mason PA. Radio frequency radiation of millimeter wave length: potential occupational safety issues relating to surface heating. HEALTH PHYSICS 2000; 78:170-181. [PMID: 10647983 DOI: 10.1097/00004032-200002000-00006] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Currently, technology is being developed that makes use of the millimeter wave (MMW) range (30-300 GHz) of the radio frequency region of the electromagnetic spectrum. As more and more systems come on line and are used in everyday applications, the possibility of inadvertent exposure of personnel to MMWs increases. To date, there has been no published discussion regarding the health effects of MMWs; this review attempts to fill that void. Because of the shallow depth of penetration, the energy and, therefore, heat associated with MMWs will be deposited within the first 1-2 mm of human skin. MMWs have been used in states of the former Soviet Union to provide therapeutic benefit in a number of diverse disease states, including skin disorders, gastric ulcers, heart disease and cancer. Conversely, the possibility exists that hazards might be associated with accidental overexposure to MMWs. This review attempts to critically analyze the likelihood of such acute effects as burn and eye damage, as well as potential long-term effects, including cancer.
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Affiliation(s)
- K L Ryan
- Air Force Research Laboratory, Directed Energy Bioeffects Division, Brooks AFB, TX 78235, USA
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Abstract
Malignancies developing in burn scars have been known for a long time and are generally epidermoid carcinomas although a few sarcoma cases have been reported. A case of fibrosarcoma developing in the burn scar was presented in this report and the literature reviewed.
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Affiliation(s)
- I Ozyazgan
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
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