Lethal Dermal Sarcoma in Immunosuppressed Patients

Oncologist. 2022 Sep 2;27(9):e759-e761. doi: 10.1093/oncolo/oyac141.

Abstract

Skin cancer is the leading malignancy in immunosuppressed patients, including organ transplant recipients (OTRs), which is increasing in incidence as OTRs live longer. We performed a single-center case series of 4 patients with scalp pleomorphic dermal sarcoma and a history of multiple keratinocyte carcinomas. Outcomes included incidence of dermal sarcoma, dermal sarcoma-related mortality, and histopathologic findings. Out of more than 200 patients followed over a 3-year period in Massachusetts General Hospital High Risk Skin Cancer Clinics, all skin cancer-related deaths (2/2) were due to metastatic dermal sarcoma. Three of 4 patients diagnosed with scalp dermal sarcoma were OTRs and had been on at least one immunosuppressive medication for a median of 9 years. For patients who died from dermal sarcoma, the median time between diagnosis and death was 6 months. Our findings suggest pleomorphic dermal sarcoma contributes to skin cancer-related morbidity and mortality in OTRs.

Keywords: dermal sarcoma; immunosuppression; organ transplant recipient.

MeSH terms

  • Humans
  • Immunocompromised Host
  • Organ Transplantation* / adverse effects
  • Sarcoma* / complications
  • Skin Neoplasms* / pathology
  • Transplant Recipients