Second cutaneous neoplasms after acute lymphoblastic leukemia in childhood

Two cases of second cutaneous neoplasms, one with adenoid cystic carcinoma of the skin and the other with basal cell carcinoma, both occurring 7 years after treatment for childhood acute lymphoblastic leukemia (ALL) are reported. Although such cutaneous neoplasms are generally reported in patients over 40 years of age, our cases, which were diagnosed at the ages of 9 and 14, are the first report of the occurrence of such cutaneous neoplasms following ALL. The neoplasms arose from the scalp of two patients who had received cranial irradiation for central nervous system prophylaxis. The possible link between leukemia therapy incorporating irradiation and the pathogenesis of second cutaneous neoplasms in the scalp is discussed.