Cancer metastasis of an unknown primary location into a postoperative kelody scar after a mine blast wound of the neck

Abstract

The connection between military trauma and cancer is not sufficiently studied. We present a clinical observation of metastasis of cancer of unknown primary localization into a keloid scar of the neck, which occurred after surgical treatment of a wound due to a previously suffered mine-explosive injury. There are no similar descriptions in the literature. The aim of this article is analysis of a clinical case of adenocarcinoma metastases in keloid scar tissue, which occurred after gunshot wounds to the body. Clinical observation. A young man, a military serviceman, developed a keloid scar after a landmine-explosive wound and primary surgical treatment of a neck wound, in which 2 years after excision, a metastasis of intestinal-type adenocarcinoma was detected (Cytokeratin-20+, Cytokeratin-7-, CDX-2+ and SATB 2+). With the help of clinical, endoscopic and radiological methods (computed tomography and positron emission tomography / computed tomography), the primary tumor and additional metastases in the neck, chest, abdominal cavity and pelvis could not be detected. The article analyzes the possible mechanisms of the rare case of metastasis of adenocarcinoma in the tissue of an uninfected keloid scar and discusses the concept of the formation of a premetastatic niche in the early stages of carcinogenesis of a preclinical tumor. Conclusions. This observation raises new questions for fundamental and translational studies of the process of hematogenous metastasis during the parallel progression of the primary tumor and its metastases.

Keywords

• metastasis
• adenocarcinoma
• scar
• keloid
• military trauma