[Epithelioma cuniculatum plantare in the region of a skin scar due to mechanical trauma. Insurance law aspects of scar carcinomas].
We herein report a case of a highly differentiated verrucous squamous cell carcinoma of the sole of the left forefoot ("epithelioma" or "carcinoma cuniculatum plantare") that had--as a specific feature--developed within a preexisting long-standing skin scar due to an earlier occupational crush injury. Because of expansive tumor growth extending to the metatarsal bones and penetrating the tissue between the tendons, an ultrashort amputation of the hindfoot was performed according to the method of Chopart. The pathogenetic mechanisms possibly underlying the formation of scar carcinomas are discussed. For judgement of legal liability insurance questions, the criteria indicating a causal relationship between traumatic scars and cancer development are presented.
Kunze
E
E
Abteilung Osteopathologie und Hämatopathologie, Zentrum Pathologie, Universität Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen. ekunze@med.uni-goettingen.de
Burchhardt
H
H
Schweyer
S
S
Thielke-Neitzel
K
K
D000062:Accidents, Occupational / Q000331:legislation & jurisprudence*; D000328:Adult; D000671:Amputation, Surgical; D018289:Carcinoma, Verrucous / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002921:Cicatrix / Q000150:complications*; D005104:Expert Testimony; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000209:etiology*; D018409:Foot Injuries / Q000150:complications*; D005545:Forefoot, Human / Q000601:surgery; D006801:Humans; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D016365:Liability, Legal; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000293:injuries* / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome