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Neglected Giant Scalp Tumors: A Report of Two Cases With an Analysis of Delay Factors
Kabita Kalita1, Rishi K Gupta1, Poresh Boruah1
1Plastic and Reconstructive Surgery, Gauhati Medical College and Hospital, Guwahati, IND.
Abstract:
Tumor neglect is a concerning phenomenon in which patients delay seeking medical attention despite the presence of obvious malignant growths. This rare and largely unexamined issue involves patients disregarding tumors as a means of coping with the outward, visible signs of cancer. Here, we present two cases of extensively neglected scalp tumors: the first, a 40-year-old male from a socially isolated community with a 26 × 22 cm squamous cell carcinoma, neglected for 14 years due to his role as the sole breadwinner, geographical isolation in a hilly region, and deep-rooted cultural beliefs in traditional healing. The second case, a 42-year-old male, presented with a 22 × 20 cm undifferentiated pleomorphic sarcoma, with a four-year delay attributed to prior experience with a benign lesion, medical anxiety, and financial constraints. Both patients exhibited massive, fungating tumors requiring complex surgical management. This report analyzes the factors contributing to extreme tumor neglect and underscores the need to address psychosocial barriers to timely medical care.
Insights
Tumor neglect, where patients ignore visible cancer, is rare. This study examines two extreme cases, highlighting psychosocial barriers to seeking timely medical care for large scalp tumors.
Area of Science:
- Oncology
- Psychosocial Medicine
- Surgical Case Reports
Background:
- Tumor neglect involves patients delaying medical care for obvious malignant growths.
- This phenomenon is often a coping mechanism to disregard visible signs of cancer.
- Understanding the drivers of tumor neglect is crucial for patient outcomes.
Observation:
- Two cases of extensively neglected scalp tumors are presented: a 26x22 cm squamous cell carcinoma and a 22x20 cm undifferentiated pleomorphic sarcoma.
- Case 1: 14-year neglect in a socially isolated male due to socioeconomic and cultural factors.
- Case 2: 4-year neglect in a male due to prior benign lesion experience, medical anxiety, and financial issues.
Findings:
- Extreme tumor neglect is influenced by a complex interplay of factors including social isolation, cultural beliefs, financial constraints, and medical anxiety.
- Massive, fungating tumors resulted from prolonged neglect, necessitating complex surgical interventions.
- Psychosocial barriers significantly impede patients from seeking timely oncological care.
Implications:
- Addressing psychosocial barriers is essential to improve early cancer detection and treatment.
- Healthcare providers must be aware of and sensitive to cultural and socioeconomic factors influencing patient care.
- Further research into the psychological underpinnings of tumor neglect is warranted.
