Keloid Surgery followed by Adjuvant Radiation Therapy (S-ART) is thought to result in superior outcomes and lower keloid recurrence rates. Although radiation therapy has been incorporated in post-operative management of keloid lesions for over 100 years, the actual long-term safety and efficacy of this intervention remains unknown and under-reported.
The author is reporting the case of an African American female who underwent S-ART for treatment of a left earlobe keloid. She remained asymptomatic for nearly 13 years before a recurrent keloid was noted at the site of the prior surgery. Despite several subsequent surgeries and a repeat course of radiation therapy, the recurrent lesion transformed into a massive keloid, impacting her daily life. To the author’s knowledge, such a delayed recurrence of keloid lesion after S-ART has not been previously reported. This case is an alarming example of many keloid patients who go through the same exact treatment pathways, undergo repeated surgeries and end up with a similar or even worse outcomes.