Dermatoses are more commonly seen in body folds and in waist areas where sari is tightened. We are presenting a rare case of saree cancer in the waistline in an 80-year-old elderly female.
An 80-year-old female presented with a long-standing swelling with oozing in the right waist. Waistline showed an ulceroproliferative cauliflower like growth measuring 8 cm × 7 cm. [Figure 1] was seen with hyper- and hypo-pigmented patches surrounding the lesion. Bilateral inguinal lymphadenopathy was present. Biopsy of growth showed well-differentiated squamous cell carcinoma (SCC) [Figure 2]. The patient gave a history of wearing saree for 70 years.
Figure 1.
Growth along right side of waist and hypopigmentation on the left side
Figure 2.
Well-differentiated squamous cell carcinoma (H and E, 100)
Khanolkar and Suryabai[1] described “dhoti cancer” in Indian males. A similar type of “saree cancer” in females was described by Patil et al.[2]
Pigmentation and mild scaling over the waist in Indian females who wear saree are so common that they consider it normal and ignore it.
The incidence of malignancy in scar tissues is 0.1%–2.5%. The malignant change in the form of SCC is seen in Marjolin's ulcer.
Wide local excision of tumor with inguinal block dissection is the treatment of choice while the combination of surgery, radiotherapy, and chemotherapy may be of extra value compared to surgery alone.[3]
SCCs which develop on chronic skin lesions have a higher incidence of metastasis (9%–36%) as compared to those arise in the previously normal skin (1%–10%). Bilateral inguinal lymph nodes were enlarged in our case. Fine-needle aspiration or biopsy of inguinal lymph nodes was not done in our case; hence, we cannot comment about metastasis.
Pigmentation and mild scaling over the waist are so common in Indian females that they consider it normal and ignore it. This case is presented for its rarity and to bring awareness about saree cancer among Indian women to detect it earlier.
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The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
References
- 1.Khanolkar VR, Suryabai B. Cancer in relation to usages; three new types in India. Arch Pathol (Chic) 1945;40:351–61. [PubMed] [Google Scholar]
- 2.Patil AS, Bakhshi GD, Puri YS, Gedham MC, Naik AV, Joshi RK. Saree cancer. Bombay Hosp J. 2005;47:302–3. [Google Scholar]
- 3.Takalkar UV, Asegaonkar SB, Kodlikeri P, Kulkarni U, Borundiya V, Advani SH. Saree cancer in Indian woman treated successfully with multimodality management. Dermatol Reports. 2014;6:5128. doi: 10.4081/dr.2014.5128. [DOI] [PMC free article] [PubMed] [Google Scholar]