Localized scleroderma in a woman irradiated at two sites for endometrial and breast carcinoma: a case history and a review of the literature.
Localized scleroderma is an uncommon side-effect of radiotherapy. We report a unique case with multiple asynchronous primary malignant tumors, which developed localized scleroderma after radiotherapy. A 67-year-old healthy woman received external irradiation for endometrial cancer. Three years later she underwent partial mastectomy and postoperative radiotherapy because of breast cancer. A progressive fibrosis developed in the breast. Within 12 months similar skin reactions were also seen in the irradiated abdominal wall and on both lower extremities. Biopsies revealed scleroderma lesions of breast and abdominal wall and scleroderma-like lesions on the legs. The lesions dissolved partially without generalization. This case, in contrast to most of the cases previously reported in the literature, illustrates not only lesions outside of radiation ports, but also that radiotherapy given to one cancer site can affect distant skin at a previously irradiated cancer site. When a localized scleroderma is diagnosed, further curative radiotherapy should be cautiously prescribed irrespective of cancer site.
Ullén
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Departments of General Oncology, Karolinska Hospital and Institute, Stockholm, Sweden. henrik.ullen@smd.sll.se
Björkholm
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D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy*; D016889:Endometrial Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D016609:Neoplasms, Second Primary / Q000532:radiotherapy*; D011832:Radiation Injuries; D011878:Radiotherapy / Q000009:adverse effects; D012594:Scleroderma, Localized / Q000209:etiology*; D013997:Time Factors