A man with a five-inch ‘dragon horn’ protruding from his back finally has it removed after discovering that it was cancerous.
The man, a 50-year-old labourer who will not be identified, ignored the growth for three years doctors said.
The growth sticking out of the mans back was found to be a large cutaneous horn (CH) – a built up of the protein keratin which forms hair, skin and nails.
Cutaneous horns, named so because they resemble the horns of animals such as rhinos, are a type of skin tumour and must be at least half as high as they are thick to be known as such.
Tests on the man's horn revealed that it was the result of a particular the of cancer known as a squamous cell carcinoma (SCC).
In the beginning, the horn would likely have begun as a small, crusty raised area of skin.
Squamous cell carcinoma usually occurs on areas of skin which have been exposed to the sun.
However, the man said that he was’t a frequent tanner and that his family had no history of skin cancer that he knew of.
When surgeons removed the huge horn from the patients back he was left with a gaping hole.
Doctors managed to reconstruct the area using a skin graft from the mans thigh.
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The Countess of Chester Hospital doctors said that the man had almost no risk factors for developing skin cancer.
They added that SCC’s as large as his can easily be missed despite public awareness of skin cancer.
In the British Medical Journal Case Reports, the team of doctors charged with the man’s care described it as a “dragon horn”.
They wrote: “We report a rare case of an extremely well-differentiated SCC that was neglected by a patient living in a developed country with access to free healthcare.
They added: “This highlights that despite current public skin cancer awareness and rigorous healthcare measures, cases like this can still arise and slip through the net.”
Dr Agata Marta Plonk and colleagues said that the man had a three year history of a lump growing on his back.
When he finally saw a doctor the horn measured 14cm, 5.5inches, long and 5.8cm, 2.3 inches, wide.
When tested the results confirmed a squamous cell carcinoma was present at the base of the horn – which was what caused it to grow.
Luckily for the man, the cancer had not spread to other parts of his body – doctors were shocked by this considering he had not received treatment.
An SCC can occur on any part of the body but is likely to occur at sun-exposed sites such as the head, neck, ears and the back of the hands.
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They vary in appearance but usually appear as scaly or crusty raised areas of skin – it may be red or inflamed, sore and tender and may bleed – though this is not always the case.
Usually SCC’s are caught and treated early which is why they do not develop into dragon-like horns.
This type of cancer is a non-melanoma skin cancer (NMSC) which is cased by a change in the DNA of cells, such as a burn.
SCC’s rarely spread and Cancer Research UK say that they are curable.
After melanoma, it is the second most common skin cancer in the UK, with 23 per cent of all 100,000 NMSC cases diagnosed per year.
While around a fifth of horns have a cancerous base, it is not yet clear why skin cancer can turn into a horn.
The horns, which are hard and yellow-brown in colour do not normally grow so huge before medical assistance is sought by the patient.
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