Sarcomatoid squamous cell carcinoma arising in a post-acupuncture keloid scar: a case report and literature review

Keloids are benign fibroproliferative skin tumors that typically arise after cutaneous injuries, such as surgical incisions, burns, lacerations, tattoos, or infections. Malignant transformation of keloids is exceedingly rare, with only sporadic reports of squamous cell carcinoma. To date, sarcomatoid squamous cell carcinoma-an uncommon, highly aggressive squamous cell carcinoma variant-has not been described in association with keloidal scars. We present the first known case of sarcomatoid squamous cell carcinoma developing within a post‑acupuncture keloid scar, detailing its clinical presentation, histopathology, and surgical management. This report underscores the importance of malignancy screening in keloids displaying atypical features, particularly in trauma-exposed regions.