The Role of Trauma in Cancer

Abstract

HomeRadiologyVol. 81, No. 6 PreviousNext EditorialThe Role of Trauma in CancerPublished Online:Dec 1 1963https://doi.org/10.1148/81.6.1039MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractThe role of trauma in the etiology of malignant neoplasms or exacerbation of tumor growth has for many years been a matter of concern to the medical profession. Radiologists in particular have had a primary interest in this problem, first because in many instances the earliest evidence of growth change is noted on the radiograph and, second, because of the radiotherapeutic implications. Trauma may be external or internal and in either instance may consist of a single acute injury or chronic repeated traumata.When malignant tumors are found following acute trauma, medicolegal aspects frequently enter the picture and considerable study may be necessary to determine the cause-and-effect relationship. Ewing (2) found it generally agreed, and it seems still to be the consensus, that a single trauma rarely produces a malignant tumor in previously normal tissue. To incriminate a single injury, the following criteria would have to be met: (1) There must be absence of previous trauma, and the trauma in question must be sufficient to produce alteration of the tissue structure. (2) There must be proof of previous integrity of the injured part. (3) The injury must have occurred at the exact point where the malignant tumor developed and not be transmitted injury. (4) There must be a reasonable time limit between the injury and the appearance of the tumor. This may vary from a few weeks to many years. (5) The nature of the tumor must be definitely identified and it must be of the type which can be referred to disordered processes of regeneration in the injured tissue.The dramatic development of metastases promptly after surgical excision or nonsurgical removal of apparently benign moles has formed the basis of the widely held impression that a single trauma may transform a benign mole into a malignant melanoma. According to Ewing, a careful scrutiny of the evidence in such cases does not support this view but indicates that the mole was already malignant prior to treatment.Aggravation of an existing tumor by acute injury appears to occur clinically, although experimental studies have not been very helpful in establishing this point. Actually, the fact of the presence of the tumor may focus the patient's memory on a long-forgotten injury. Ewing believed that the probability of coincidence is much greater than is generally recognized. In a recent communication, Krebs and Olsen (3) report that, in two series totaling 126 cases, 43 were accepted as “caused by or aggravated by traumatic injury.” A critical reappraisal, however, shows that in only 2 instances was it impossible to rule out the injury as a cause of the disease. These authors detail 4 cases of fracture or bone injury in which sarcoma was diagnosed several months later.Article HistoryPublished in print: Dec 1963 FiguresReferencesRelatedDetailsCited ByMulti‐modality imaging of aggressive submural neoplasia of the hoof in two horsesHNagel, HLang, ASole Guitart, NLean, RAllavena, CSprohnle‐Barrera, AYoung2022 | Australian Veterinary Journal, Vol. 100, No. 7Systematic review of the epidemiology of a single physical trauma and cancerDamien MMcElvenny, AliceDavis, KenDixon, CarlaAlexander, GirishGupta, IoannaNixon, Joanne OCrawford2021 | Trauma, Vol. 23, No. 3Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 81, No. 6 Metrics Altmetric Score PDF download