Rhabdomyosarcoma at site of pacemaker implantation.

Background. Malignant proliferation at the site of implantation of a pacema ker generator is uncommon. We report the case of a patient who developed rh abdomyosarcoma. Case report. A 85-year-old man presented with a voluminous and rapidly evol ving tumor localised beneath the right clavicle. This inflammatory and necr otic lesion developed on the area where a titanium pacemaker had been impla nted five years earlier. Rhabdomyosarcoma was diagnosis on the basis of imm unohistochemistry findings. In spite of a wide surgical excision of this pr imitive tumour, visceral dissemination appeared, rapidly leading to the pat ient's death. Discussion. This observation rises the question of the role of the pacemake r implantation in tumor development. The excellent in vivo tolerance and th e widespread utilization of titanium as biomaterial is an argument against its carcinogenic action. Inversely, a metal-related chronic inflammatory re action could favor the neoplastic process in predisposed subjects as has be en observed with prosthetic materials used in orthopaedics.