Development of Malignant Peripheral Nerve Sheath Tumor After Keloid Treatment
Summary:. A malignant peripheral nerve sheath tumor is a rare and aggressive soft-tissue sarcoma that originates from Schwann cells or neural crest cells. Although 60% of cases are associated with neurofibromatosis type 1, approximately 10% occur secondary to radiotherapy. We report a malignant peri...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-07-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006965 |
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| author | Natsuki Seo, MD Takashi Nuri, MD, PhD Akinori Asaka, MD Hiroko Kuwabara, MD, PhD Yoshinobu Hirose, MD, PhD Koichi Ueda, MD, PhD |
| author_facet | Natsuki Seo, MD Takashi Nuri, MD, PhD Akinori Asaka, MD Hiroko Kuwabara, MD, PhD Yoshinobu Hirose, MD, PhD Koichi Ueda, MD, PhD |
| author_sort | Natsuki Seo, MD |
| collection | DOAJ |
| description | Summary:. A malignant peripheral nerve sheath tumor is a rare and aggressive soft-tissue sarcoma that originates from Schwann cells or neural crest cells. Although 60% of cases are associated with neurofibromatosis type 1, approximately 10% occur secondary to radiotherapy. We report a malignant peripheral nerve sheath tumor that developed after radiotherapy for a keloid. A 35-year-old woman presented with a 7 × 9 cm left shoulder lesion 11 years after surgical treatment of a keloid followed by radiotherapy (20 Gy). Four years earlier, she had undergone a second operation with postoperative radiation (25 Gy) to address keloid recurrence. Biopsy was concerning for malignancy, the tumor was resected with a 2-cm margin, and reconstruction was performed using a latissimus dorsi flap. The lesion exhibited erosion and hemorrhage not seen in benign keloids, and histological examination of the surgical specimen revealed high-grade sarcoma. No recurrence has been observed during follow-up. The development of secondary malignancy after radiotherapy for keloids is exceedingly rare—only 6 cases have been reported, including ours. However, clinicians must be vigilant in all keloid patients undergoing radiotherapy. Rapid enlargement, erosion, or bleeding in previously treated keloids should raise suspicion for malignant transformation. Proper radiation protocols and protective measures are essential to mitigate the risk. Early recognition and surgical intervention are critical for achieving favorable outcomes. |
| format | Article |
| id | doaj-art-9ce110b929fd4fb59d15a727bd85c810 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-9ce110b929fd4fb59d15a727bd85c8102025-08-20T03:55:49ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-07-01137e696510.1097/GOX.0000000000006965202507000-00046Development of Malignant Peripheral Nerve Sheath Tumor After Keloid TreatmentNatsuki Seo, MD0Takashi Nuri, MD, PhD1Akinori Asaka, MD2Hiroko Kuwabara, MD, PhD3Yoshinobu Hirose, MD, PhD4Koichi Ueda, MD, PhD5From the * Department of Plastic and Reconstructive Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, JapanFrom the * Department of Plastic and Reconstructive Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, JapanFrom the * Department of Plastic and Reconstructive Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan† Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.† Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.From the * Department of Plastic and Reconstructive Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, JapanSummary:. A malignant peripheral nerve sheath tumor is a rare and aggressive soft-tissue sarcoma that originates from Schwann cells or neural crest cells. Although 60% of cases are associated with neurofibromatosis type 1, approximately 10% occur secondary to radiotherapy. We report a malignant peripheral nerve sheath tumor that developed after radiotherapy for a keloid. A 35-year-old woman presented with a 7 × 9 cm left shoulder lesion 11 years after surgical treatment of a keloid followed by radiotherapy (20 Gy). Four years earlier, she had undergone a second operation with postoperative radiation (25 Gy) to address keloid recurrence. Biopsy was concerning for malignancy, the tumor was resected with a 2-cm margin, and reconstruction was performed using a latissimus dorsi flap. The lesion exhibited erosion and hemorrhage not seen in benign keloids, and histological examination of the surgical specimen revealed high-grade sarcoma. No recurrence has been observed during follow-up. The development of secondary malignancy after radiotherapy for keloids is exceedingly rare—only 6 cases have been reported, including ours. However, clinicians must be vigilant in all keloid patients undergoing radiotherapy. Rapid enlargement, erosion, or bleeding in previously treated keloids should raise suspicion for malignant transformation. Proper radiation protocols and protective measures are essential to mitigate the risk. Early recognition and surgical intervention are critical for achieving favorable outcomes.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006965 |
| spellingShingle | Natsuki Seo, MD Takashi Nuri, MD, PhD Akinori Asaka, MD Hiroko Kuwabara, MD, PhD Yoshinobu Hirose, MD, PhD Koichi Ueda, MD, PhD Development of Malignant Peripheral Nerve Sheath Tumor After Keloid Treatment Plastic and Reconstructive Surgery, Global Open |
| title | Development of Malignant Peripheral Nerve Sheath Tumor After Keloid Treatment |
| title_full | Development of Malignant Peripheral Nerve Sheath Tumor After Keloid Treatment |
| title_fullStr | Development of Malignant Peripheral Nerve Sheath Tumor After Keloid Treatment |
| title_full_unstemmed | Development of Malignant Peripheral Nerve Sheath Tumor After Keloid Treatment |
| title_short | Development of Malignant Peripheral Nerve Sheath Tumor After Keloid Treatment |
| title_sort | development of malignant peripheral nerve sheath tumor after keloid treatment |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006965 |
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