The development of squamous cell carcinomas in split-thickness skin graft donor sites

Morritt, Daniel G.; Khandwala, Asit

doi:10.1007/s00238-012-0786-z

Cited by 6 publications

(7 citation statements)

References 13 publications

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“…2 The development of SCC in donor sites following split skin graft harvest is rare. 3 To date there are only eleven documented cases (n ¼ 11) in the literature (Table 1). Considering the initial histology in this case had features of KA we included four further cases of reported KA in donor sites.…”

Section: Discussionmentioning

confidence: 97%

Squamous cell carcinoma arising in a skin graft donor site following melanoma extirpation at a distant site: A case report and review of the literature

et al. 2015

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s u m m a r yThe development of both squamous cell carcinoma (SCC) and keratoacanthoma (KA) in donor sites following split thickness skin graft harvest are rare complications reported in the literature. Management of such cases requires a precise distinction between keratoacanthoma and SCC and knowledge of the degree of differentiation. We describe the case of a 48-year-old male who developed a squamous cell carcinoma with features of KA within a donor site on his right thigh. This developed six weeks following split skin graft harvest to cover a defect on his right anterior chest following wide local excision of a 2.4 mm Breslow thickness superficial spreading melanoma. We review previous cases in the literature along with theories suggested for their development and conclude the development of SCC with features of KA in this reported case was likely a de novo lesion. This case highlights the need for evaluation of the donor site at all surveillance examinations of the primary tumor site and urgent diagnostic biopsy of all non-healing and new lesions.

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Section: Discussionmentioning

confidence: 97%

Squamous cell carcinoma arising in a skin graft donor site following melanoma extirpation at a distant site: A case report and review of the literature

et al. 2015

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“…First, implantation metastases due to direct surgical contamination of the site with viable tumour cells 4 5. Isolated metastases in graft/flap donor site are rare for skin cancer with the reported incidence of recurrent melanoma in skin graft donor site of 1%–8% 4–6. Metastasis at bone graft donor sites associated with primary osteosarcoma and giant cell tumour has been described 7–10.…”

Section: Discussionmentioning

confidence: 99%

“…The alternative hypothesis for graft/flap donor site metastases is via haematogenous spread. Inflammatory and proangiogenic environment at the donor site in the postoperative period may promote tumour homing due to affinity of circulating tumour cells to the hypervascular environments 6 10 11…”

Section: Discussionmentioning

confidence: 99%

Left cheek sclerosing rhabdomyosarcoma and development of isolated free flap donor site metastasis

et al. 2022

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Rhabdomyosarcoma is a rare mesenchymal malignancy with four different morphological subtypes: alveolar, embryonal, pleomorphic and spindle cell/sclerosing. It is the most common soft tissue sarcoma of children and adolescents but occurs less commonly in adults. We describe a male patient in his 20s with sclerosing rhabdomyosarcoma of the left cheek who developed an isolated free flap donor site metastasis in the first instance but subsequently progressed with bilateral pulmonary metastases. Multidisciplinary team involvement in a sarcoma specialist centre is essential and collaboration between the pathologist, radiologist, head and neck surgeon, orthopaedic surgeon, radiation oncologist and medical oncologist were integral in providing optimal management in this patient. Furthermore, this case report highlights this phenomenon of implantation metastasis in a patient with rhabdomyosarcoma, and emphasises the importance of surgical barriers between the resection and reconstruction teams in an oncological case.

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“…The patient immune system must also be taken into account. Immunodeficiency induced by drugs or other diseases, such as hematologic disorders, may explain the propensity for the development of cancer, inducing a generalized 'field of cancerization' that can induce a Koebner phenomenon and the development of new cutaneous cancers in the site of surgery [17,[21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…ESCC have been reported to arise at the sites of skin surgery, including the area affected by the primary tumor and split thickness skin graft (STSG) donor and recipient sites [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The best therapeutic option for ESCC after surgery in our opinion is still a challenge.…”

Section: Introductionmentioning

confidence: 99%

Eruptive non-melanoma skin cancers/squamous atypia following skin surgery. Report of two new cases, concise review of the literature with special emphasis on treatment options

Chessa

Picciola

Filippi

et al. 2022

Dermatol Pract Concept

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Multiple eruptive cutaneous non-melanoma skin cancers(NMSCs) have been reported to arise at the sites of skin surgery, including the area affected by the primary tumour and split thickness skin graft(STSG) donor and recipient sites. The aim of this study is to make a critical revision of the literature, analysing the clinical, histological features and outcomes of eruptive NMSCs after cutaneous surgery. Up to August 2021, according to our systematic review of the literature, we have collected 18 published articles and a total of 33 patients, including our two cases. The results of this review highlight five red flags that clinicians should consider: (i) lower and upper limbs represent the cutaneous site with the highest risk, representing 82.35% of the cases in the literature; (ii) the median time to onset of eruptive NMSCs that is approximately 6 weeks; (iii) primary NMSCs were completely excised with free margins on histologic examination in all cases of the literature, and therefore the eruptive NMSCs reported could not be considered recurrences; (iv) any surgical technique involves a risk to promote eruptive NMSCs; (v) treatment of eruptive NMSCs includes surgery or combined surgical and medical treatment. However, eruptive NMSCs recurrences are a real medical challenge and have always been treated combining surgical and medical treatment, with complete resolution in about one third of patients. In conclusion, even though the pathogenesis remains unclear, this review highlights 5 red flags which could support clinicians in the diagnosis and management of eruptive of NMSCs after skin surgery.

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The development of squamous cell carcinomas in split-thickness skin graft donor sites

Cited by 6 publications

References 13 publications

Squamous cell carcinoma arising in a skin graft donor site following melanoma extirpation at a distant site: A case report and review of the literature

Squamous cell carcinoma arising in a skin graft donor site following melanoma extirpation at a distant site: A case report and review of the literature

Left cheek sclerosing rhabdomyosarcoma and development of isolated free flap donor site metastasis

Eruptive non-melanoma skin cancers/squamous atypia following skin surgery. Report of two new cases, concise review of the literature with special emphasis on treatment options

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