title: [Neglected skin tumors. Three cases].
abstract: BACKGROUND
  Giant skin tumours are defined as greater than 10 cm in size and are frequently a consequence of neglect. We report three cases of giant skin tumours and discuss possible factors associated with delayed diagnosis and treatment.
  
  
  METHODS
  Two men and one woman, aged 52, 62 and 78 years, presented with giant skin tumours. One was mentally retarded, one had a borderline personality and another was presenting a major depressive disorder. Pain, smell, bleeding and/or loss of function forced the patients to seek medical care. Tumour sizes were 11 to 30 cm and were present for between six months and 20 years. All patients had hidden their lesion from their doctor and families. In one case, a sebaceous carcinoma of the right shoulder required amputation of the right upper limb. In a second, palliative surgery and medical care was given for a metastatic porocarcinoma. The last patient received neoadjuvant chemotherapy for an undifferentiated carcinoma.
  
  
  CONCLUSIONS
  Neglected skin tumours continue to be encountered even in 2011. Consultation was delayed due to fear of the diagnosis and/or lack of corresponding physicians, resulting in worsening of the prognosis. A larger scale study could help us to identify the factors associated with neglected giant tumours and to improve their management.
authors.affiliation: Service de dermatologie, hôpital Henri-Mondor, faculté de médecine Paris-Est-Créteil, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: O
authors.initials: O
authors.lastname: Zehou
authors.forename: L
authors.initials: L
authors.lastname: Valeyrie-Allanore
authors.forename: N
authors.initials: N
authors.lastname: Ortonne
authors.forename: K
authors.initials: K
authors.lastname: Chazelas
authors.forename: M
authors.initials: M
authors.lastname: Hivelin
authors.forename: A
authors.initials: A
authors.lastname: Marchac
authors.forename: O
authors.initials: O
authors.lastname: Chosidow
authors.forename: P
authors.initials: P
authors.lastname: Wolkenstein
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology / Q000523:psychology / Q000628:therapy; D057210:Delayed Diagnosis; D003717:Denial, Psychological; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D018450:Disease Progression; D057090:Eccrine Porocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000523:psychology / Q000628:therapy; D005260:Female; D005834:Genital Neoplasms, Male / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D006801:Humans; D055809:Illness Behavior; D008607:Intellectual Disability / Q000175:diagnosis / Q000523:psychology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010166:Palliative Care; D012626:Sebaceous Gland Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000523:psychology / Q000628:therapy; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D047368:Tumor Burden
chemical_list: D000970:Antineoplastic Agents