Skin Cancer Patient Relapses After Delayed Treatment

This case involves a 45-year-old female patient who had a biopsy done of a growth on her neck. The specimen was described as basal cell carcinoma but the patient’s mass was not surgically resected at the time of diagnosis. Two months later, the patient saw significant growth in the area and consulted another pathologist for a second opinion. The pathologist diagnosed the patient’s chest mass as advanced hidradenocarcinoma, which required immediate surgical intervention. Following removal of the tumor, the patient did not respond positively to her radiation or chemotherapy treatment. She eventually relapsed and succumbed to her cancer. A radiation oncologist was sought to review the records and determine whether the delay in initiating radiation therapy might have affected prognosis.

Question(s) For Expert Witness

1. Have you ever treated hidradenocarcinoma?

3. How important is the timely initiation of radiation therapy post surgery for hidradenocarcimona?

Expert Witness Response E-007207

I regularly use irradiation therapies to treat a variety of skin carcinomas, both rare and common. Hidradenocarcinoma is an extremely rare variant of skin cancer. Additionally, I have published peer-reviewed work on the application of irradiation treatments to skin carcinomas. Even if irradiation is recommended, there is no form of skin cancer for which surgical intervention is not within the standard of care. I am surprised that the patient's mass was not surgically resected at the initial diagnosis. I would be happy to review the medical records related to this case in order to understand the course of irradiation treatment that the patient underwent, the duration of the treatment, and any indicators that might have appeared during treatment that would require a reconsideration of the patient's treatment regime or diagnosis.