Progressive systemic sclerosis (diffuse scleroderma) and radiotherapy

The rheumatological manifestations of cancer are many and varied. Progressive systemic sclerosis has been reported both as an initial manifestation of malignancy (Caldwell & McCallum, 1986) and, of course, as coexisting with malignant disease. Surprisingly, only one case report is to be found in the literature reporting on the interaction between radiotherapy and scleroderma (Ransom & Cameron, 1987), the consequences of which may carry significant morbidity. Our patient was 49 years old in May 1987 when referred for the management of a mass in the right neck. This right cervical node measured 6 × 5 cm, was fungating through the skin, with biopsy confirming metastatic squamous cell carcinoma. No primary site was identified either on direct ear, nose and throat examination or with computed tomography.