High-Grade Pleomorphic Sarcoma in Postauricular Keloid Scar After Surgical Excision and Radiation

Keloid scars can cause significant morbidity to the patient including substantial cosmetic disfigurement, particularly in the head and neck region. Surgical excision followed by immediate postoperative radiation therapy has been shown to be more effective than single modality treatment. Radiation therapy increases risk for radiation-induced malignancy, though very few cases have been reported in the treatment of keloids. We report the case of a patient with a large postauricular keloid treated with excision and immediate post-operative radiation who developed a high-grade pleomorphic sarcoma in the scar bed. Laryngoscope, 2024 We report the case of a patient with a large postauricular keloid treated with excision and immediate post-operative radiation who developed a high-grade pleomorphic sarcoma in the scar bed. To our knowledge, this is the first reported case of high-grade pleomorphic sarcoma arising in a radiated keloid scar bed in the head and neck. This finding demonstrates that it is important to consider risk of radiation-induced malignancy when prescribing radiotherapy for the post-excision treatment of keloids. image