title: [Historic malignant tumour: 27 observations].
abstract: BACKGROUND
  When used in the French medical literature to describe a pathological state, the word "historic" normally refers to tumours of startling appearance because of their size. It is difficult to understand how a patient can allow such tumours to continue to grow. We attempt to define this concept.
  
  
  METHODS
  Two dermatologists carried out a retrospective, independent and comparative selection of photographs taken between 1978 and 2008 of malignant cutaneous tumours of unusual size given the histological diagnosis. Socio-professional, demographic, clinical, histological psychological data, and details of treatment history and progress were collected.
  
  
  RESULTS
  Twenty-seven patients (11 M, 16 F) of mean age 74 years (34-99 years) presented a "historic" tumour. Twelve patients lived in rural regions. Five patients were company executives. The average duration of development of the "historic" tumours was 4.5 years (6-420 months). The tumours were classed histologically as epidermoid carcinomas (nine) and melanomas (seven). The mean size was 13 cm (6-30 cm). Psychiatric problems, membership of sects or dementia were noted for 13 patients. Treatment consisted of chemotherapy, radiotherapy or, less frequently, surgery. Eighteen patients died on average 13 months after diagnosis.
  
  
  CONCLUSIONS
  "Historic" malignant tumour (also described in the literature as "giant" tumour) is a real-life fact. No studies have been made of a series of such patients. Despite histological diagnosis, the size was associated with slow tumoral progress and/or late treatment, chiefly accounted for by psychiatric disorders. Socio-professional data indicate that "historic" tumours are equally common in urban and rural areas.
authors.affiliation: Service de dermatologie et vénéréologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France. antoine.petit@sls.aphp.fr
authors.forename: A
authors.initials: A
authors.lastname: Sparsa
authors.forename: V
authors.initials: V
authors.lastname: Doffoel-Hantz
authors.forename: H
authors.initials: H
authors.lastname: Durox
authors.forename: J
authors.initials: J
authors.lastname: Gaston
authors.forename: M
authors.initials: M
authors.lastname: Delage-Core
authors.forename: C
authors.initials: C
authors.lastname: Bédane
authors.forename: F
authors.initials: F
authors.lastname: Labrousse
authors.forename: J P
authors.initials: JP
authors.lastname: Sannajust
authors.forename: J-M
authors.initials: JM
authors.lastname: Bonnetblanc
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D057210:Delayed Diagnosis; D003717:Denial, Psychological; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D012959:Socioeconomic Factors; D016019:Survival Analysis; D047368:Tumor Burden