Co-existence of basal cell carcinoma and squamous cell carcinoma in a single burn scar region

Abstract

An 81-year-old man presented to our hospital for the evaluation of two tumors located on a burn scar at his right temple. The patient had suffered a thermal burn to his temple from a hearth at one year old. One year before his consultation, two tumors simultaneously developed and had progressively grown. The tumors were surgically resected with margins; thereafter, full thickness skin grafting was performed. A histological examination revealed that the tumors were histologically squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). The patient is now being carefully observed. SCC is a malignant tumor that originates from epidermal keratinocytes and occasionally develops from burn scars. In post-burned lesions, scars or any other chronic wound, malignant degeneration typically ensues over a period of time. Skin cancers that develop from burn scars are considered more aggressive than other types of skin cancer and showed higher rates of regional metastasis and mortality. BCC is the most common skin malignancy and arises from basal keratinocytes of the interfollicular epidermis or hair follicle; burn scars are rarely associated with it. To our knowledge, there have been very few case reports published concerning burn scar carcinomas comprising both SCC and BCC. We herein report a unique case in which SCC and BCC co-existed within a single burn scar region on the temple with a review of the literature concerning burn scar carcinogenesis.