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Dr. Andrew Rynne

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Can chemotherapy cause inflammation under the biopsy scar tissue?

Answered by
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Dr. Monish De

Oncologist

Practicing since :2004

Answered : 1802 Questions

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Posted on 4 days ago in Skin Cancer
Question: My husband is going through chemo for lung cancer. His prognosis is very good because it was caught so early and they were able to do a lobectomy. But my question actually relates to a melanoma he had 10 years ago. Like his lung cancer, it was caught early on when a small mole was biopsied. It was taken out, the margins were clear and he was fine except for a 2 inch scar it left behind. Recently, my husband has been complaining of tenderness in the area where the biopsy was taken so many years ago. I can visually see an inflammation of tissue underneath the skin adjacent to the scar but there is no discoloration on the epidermis. I can palpate a 2 inch circular growth that is immovable. I is tender at times. Regardless, I am concerned about a subcutaneous recurrence on the scar, but am wondering if the chemo he is on could create this from attacking scar tissue. Also, do recurrences on scar tissue tend to occur 10 years post biopsy? Also, my husband had a Pet Scan in November after his lobectomy and it was. If it were recurrent wouldn't it have showed up on the Pet Scan?

I meant to say that his Pet Scan was clear in November.
doctor
Answered by Dr. Monish De 46 minutes later
Brief Answer:

No chance of recurrence

Detailed Answer:

Hi,

After hearing the history I think as the pet scan was clear in November there is no chance of recurrence after such a long time.

The raised nodule in the biopsy area is a keloid tissue which is a benign condition and there is no chance of malignancy returning.

Chemotherapy has caused this raised nodule formation as it had killed all the cancer cells which have to lead to the formation of this nodule and it consists mostly of dead cells.

If it is bothering then it can be surgically removed by excision by a general surgeon

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Monish De 1 hour later
Thank you. I do need some clarification regarding your statement, "Chemotherapy has caused this raised nodule formation as it had killed all the cancer cells which has lead to formation of this nodule and it consist mostly of dead cells." His oncologist said that it appeared they had gotten all of his lung cancer in the lobectomy, albeit there was cancer in 1 of 4 lymph nodes in the lung that was removed. It was explained that the cancer was trying to work its way out. The chemo was just to kill anything that may have gotten out. So, I guess my question is are you saying that the nodule on his back adjacent to his old melanoma scar is likely an accumilation of dead cancer cells from the chemo? Why would they conjugate into this area? The nodule that I am referring to doesn't feel like keloid scarring at all. I have uploaded a photo for you. Thank you very much.
doctor
Answered by Dr. Monish De 2 hours later
Brief Answer:

Punch biopsy suggested

Detailed Answer:

Hi,

I have gone through your picture.

As your husband has a history of melanoma and is undergoing chemotherapy for lung cancer and now has tenderness in the area where the biopsy was taken so many years ago.

And you can visually see inflammation of tissue underneath the skin adjacent to the scar but there is no discolouration on the epidermis and can palpate a 2-inch circular growth that is immovable and his PET scan in November is normal but still.

I would advise him to undergo a punch biopsy to rule out recurrence on the scar

In a punch biopsy, a tool is used which looks like a tiny round cookie cutter to remove a deeper sample of skin.

The punch biopsy tool on the skin is rotated until it cuts through all the layers of the skin.

The sample is removed and studied by pathologists to rule out any recurrence.

The edges of the biopsy site are often stitched together.

You can consult a general surgeon for punch biopsy

Melanoma can recur after 10 years in more than 6 Percent of patients.

Hope I have answered your query.

Take care

Regards,
Dr Monish De, Oncologist
Above answer was peer-reviewed by : Dr. Kampana
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