• Vol. 41 No. 11, 536–537
  • 15 November 2012

Multiple Basal Cell Carcinomas Arising in a Surgical Scar After Radiotherapy

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A 53-year-old male presented with a 5-month history of dysphagia, cough and chest pain. Computed tomography revealed a mass in mediastin which was suspicious of thymoma. The adjacent organs were involved, but no pericardial or pleural implants were observed (State III). Surgical excision was performed. Histologically, the tumour contained a mix of fusiform and epitheliod shaped cells with invasion into the thymus capsule. These histological findings were consistent with thymoma type AB, according to the World Health Organization classification. Adjuvant radiotherapy was initiated after surgery with total remission (total dose 40 Gy). Six months later, the patient was referred to our clinic with complaint of erythematous plaques over the surgical scar. Lesions appeared slowly, increasing in size progressively. They were pruritic and non-tender. Clinical examination showed 3 erythematous plaques arising on the scar of the sternotomy, with well-delimited pearly edges and serohematic crusts on surface (Fig. 1). Basal cell carcinomas were considered as diagnosis and the lesions were excised. Microscopic exam showed basaloid tumoural nests enclosed by connective tissue stroma budding from the epidermis, confirming the clinical suspicion (Fig. 2). The edges of resected tissue were free of tumour cells.

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