Saree cancer in Indian woman treated successfully with multimodality management

Abstract

Saree is a common, traditional garment of Indian women, wrapped around the waist is tightened by a thick cord and with one end draped over the shoulder. Tight knot in the same place, sweat, soiling and continuous use can cause pigmentation, scaling of the waist and even transform to malignancy. We present here a case of saree cancer successfully managed with multimodality therapy. A 50-year-old woman was referred to our hospital (India) for itching and non-healing ulcerative lesion on waistline. She was wearing saree continuously for 34 years with knot at the same place. Magnetic resonance images suggested ulcerative growth with lymph node metastasis. She then underwent wide local excision; histopathological examination confirmed it was a squamous cell carcinoma. She therefore received concomitant chemotherapy and radiotherapy. She is now (2 years after the completion of treatment) in remission state. Awareness of saree cancer among Indian is important to avoid malignant lesions at waistline. Multimodality management with surgery, chemotherapy and radiotherapy is ideal mean for good outcome.

Dhoti cancer revisited

“…[28] It is suggested that lymph node involvement occurs if the malignancy involves the surrounding skin or the underlying muscles. [9] The CECT scan of our patient showed no underlying muscle and bone involvement apparently the reason for no lymph node involvement. We feel CECT scan should be done in all such cases to elucidate the involvement of any underlying soft tissue, bone, or lymph node.…”

Cutaneous Squamous Cell Cancer on the Waistline Associated with Saree-wearing: A Case Report and Literature Review

“…In 4 cases reactive inguinal lymphadenopathy was described ( 2 , 4 , 8 , 12 ). In 2 cases nodal metastases were identified, 1 case was identified on inguinal block node dissection and no follow-up data is available, in the other case patient underwent chemotherapy with paclitaxel and carboplatin followed by surgical resection and chemotherapy and maintained remission at the time of report 2 years after treatment ( 7 , 10 ).…”

“…Saree and dhoti cancers were first described in India in 1945 as waistline cSCCs appearing within friction lines corresponding with waistline drawstrings (1). At least 11 further cases of saree/dhoti cancer have been published since then (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Overall, 72% are reported in females, the median duration of saree/dhoti use before cSCC development is 50 years, the median diameter of cSCCs at the time of excision was 7 cm and, in 4 cases, other skin changes were noted, particularly involving the contralateral waistline skin and most commonly described as hypopigmentation and scaling, as in the current case.…”

Saree cancer post wide excision presenting with metastatic lesion in inguinal region. First reported case

“…Hence our experience suggests that in case of more advanced cases of saree cancer, a combination of surgery, radiotherapy and chemotherapy may be of extra value compared to surgery alone. 8 …”