CTICasesThoracotomy-Induced Keloid Formation
Imaging findings
Chest CT in a patient post-double lung transplant for sarcoidosis shows multiple prominent, lobulated, cutaneous soft-tissue plaques and fungating masses along the anterior chest wall and back. On coronal reformats, the anterior chest lesions follow the precise curvilinear track of a prior clamshell thoracotomy incision, confirming exuberant keloid formation at the surgical scar sites. The patient also demonstrates signs of restrictive allograft syndrome with upper-lobe-predominant fibrosis.
Key takeaways
Keloids are benign dermal fibroproliferative lesions that occur secondary to skin injury and uncontrolled wound healing in susceptible individuals. Surgical incisions (such as thoracotomy scars) are a classic trigger, and chest wall incisions can lead to extensive, truncal keloids that may mimic cutaneous malignancies (such as cutaneous T-cell lymphoma) on imaging.
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