title: Squamous cell carcinoma occurring within incision of recently implanted spinal cord stimulator.
abstract: Spinal Cord Stimulation (SCS) is a treatment option for chronic pain patients. Spinal cord stimulation has been employed in the treatment of chronic pain for more than 30 years. The most common indication for SCS is the failed back syndrome with leg pain. Its indications have expanded beyond back and lower extremities pain to include axial low back pain, CRPS, mesenteric ischemia, peripheral neuropathy, limb ischemia, and refractory angina pectoris. The SCS has become a more versatile form of analgesia. The number of wound complications will surely rise in conjunction with the increasing number of devices being implanted. We describe a case of a well-differentiated squamous cell carcinoma occurring within the incision site of a recently implanted spinal cord stimulator early in the postoperative period. The patient developed a rapidly growing mass within the leads incision. The mass was confirmed to be squamous cell carcinoma by biopsy. The mass was excised under local anesthesia with appropriate margins. It was determined that the carcinoma did not extend below the dermis, and that there was no involvement of the underlying fascia. The device was tested for proper functioning, and the leads were thus left in place. While the development of skin malignancies in surgical wounds has been described in the literature, to our knowledge there have been no reports of a cutaneous neoplasm developing early in the postoperative period after spinal cord stimulator implantation.
authors.affiliation: Department of Anesthesiology, University of Kentucky Chandler Medical Center, Lexington, KY, USA. jatallah99@yahoo.com
authors.forename: Joseph
authors.initials: J
authors.lastname: Atallah
authors.forename: Justin
authors.initials: J
authors.lastname: Wainscott
authors.forename: David
authors.initials: D
authors.lastname: Sloan
authors.forename: Karabeth
authors.initials: K
authors.lastname: Moore
authors.forename: Brenda G
authors.initials: BG
authors.lastname: Fahy
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D020918:Complex Regional Pain Syndromes / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013116:Spinal Cord / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000150:complications; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects