Pleomorphic undifferentiated sarcoma arising in a burn scar: Report of a case and review of literature

The skin is the largest organ in the human body, and skin cancers are some of the most common malignancies seen across the world. About 80% of all skin cancers are basal cell carcinomas (BCC), 16% are squamous cell cancers (SCC), and 4% are melanomas. In contrast, the most common cancers that arise in a burn scar are squamous cell cancers. The burned area is at risk of constant and chronic irritation due to activities of daily living because the covering lacks hydration and elasticity, as compared to normal skin. Malignant transformation of these areas is accelerated by the prolonged duration of the ulcer, injury, constant irritation, infection, and poor hygiene. There have been anecdotal reports of sarcomas arising in a burn scar, with a total of 21 cases being reported so far in the literature. We present the clinical and pathological details of a 50-year-old lady with a pleomorphic undifferentiated sarcoma arising from a neglected burn scar, who needed palliative surgery to relieve her pain. This case report focuses attention on an unusual presentation of an aggressive tumor in the background of a neglected burn scar and emphasizes the need for early and appropriate management of all non-fatal burn patients.