Das Narbeneareinom — eine zu seltene Diagnose

Summary

48 cases of carcinoma in scar tissue were treated at the Surgical Clinic of Graz University between 1957 and 1968. They were seen in scars due to burns (7) and lesions (8), chronic ulcers (9) and fistulae (8). Radiation sequelae (16) were included in the series, in accordance with the opinion of many authors.

Cancers in burn scars invariably occurred in contractures after 7 to 67 (44) years, often after long periods of ulceration. Carcinomas in scars after injuries mostly was observed on parts of the body exposed to repeated irritation and small insults after 20 to 45 (29) years. Ulcers of the leg in 0.8% of our patients showed malignant degeneration after 20 to 42 (34) years of existence. Carcinomas in fistulae were found 19 to 47 (35) years after suppuration began. The 103 cases of operated radiation sequelae included 12 squamous-cell carcinomas, 1 fibrosarcoma and 3 b asal cell epitheliomas. Time elapsed since radiotherapy—excluding 3 cases of occupational cancer—was 7 to 40 (25) years.

The long period of latency and the increasing expectation of life explain the apparent increase in this “rare” cancer of scar tissue. Out of 46 cases operated on for scar cancers, the tumor was exstirpated in 35 and the skin defect restored by plastic surgery. The 11 cases requiring amputations and the short survival time of 20 other patients are evidence that treatment was begun too late. Thus, not only must the time lag in diagnosing malignancy be shortened but above all prophylactic treatment for cancer with elimination of the precancerous conditions must be instituted.

Zusammenfassung

An 48 Narbencarcinomen, die an der Chirurgischen Universitätsklinik Graz in der Zeit von 1967 bis 1968 zur Aufnahme kamen, werden die therapeutischen Maßnahmen besprochen und die Behandlungsergebnisse dargelegt. Die erschütternde Bilanz ist vor allem der diagnostischen Versehleppungszeit zuzuschreiben. Es wird daraus die Forderung abgeleitet, die hier einfach zu realisierende Carcinomprophylaxe zeitgerecht durchzuführen.