Pleomorphic Dermal Sarcoma on Burn Scar: A Case Report

Abstract

Pleomorphic dermal sarcoma (PDS), a cutaneous form of undifferentiated pleomorphic sarcoma, is a rare, aggressive sarcoma that is known to develop on locations exposed to ultraviolet light. Here, we describe a unique case of PDS that developed on a burn scar with little ultraviolet light exposure. Most neoplasms from burn scars have an ectodermal origin, but our case was distinctive in that the neoplasm originated from the mesoderm. The 52-year-old patient, who had sustained a burn injury 40 years earlier, had suffered a small abrasion on his burn scar 3 months prior; the scar underwent rapid exophytic growth after repeated insult. After wide excision of the tumor with a clear resection margin and reconstruction with a skin graft, neither recurrence nor distant metastasis was reported. To our knowledge, this is the first case of diagnosis and successful management of a PDS originating from a burn scar. We discuss the diagnosis and management of this rare type of sarcoma, as well as its probable pathophysiologic mechanism related to burn scars. This case highlights the need for clinicians to promptly investigate patients with chronic wounds on their burn scars and to include PDS as one of the differential diagnoses.