January 26, 1976

Cancer at Insulin Injection Site

Author Affiliations

Mountain View, Calif

JAMA. 1976;235(4):374. doi:10.1001/jama.1976.03260300012011

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To the Editor.—  Regarding the report of a mesenchymoma in the subcutaneous tissue of the thigh of an insulin-dependent diabetic (233:985,1975), I believe the conclusions of the authors are overdrawn.I do not wish to demean the importance of good, thorough, case reporting in the advancement of the science of medicine, nor of the importance of observed serendipitous (or so they may seem) associations of two or more phenomena; however, the subject of the role of trauma in the induction of malignancy, as the authors point out, is long, and after decades of attempts at firming up the association, I am not convinced the validity of the proposition has been established.More specifically, the statement that "the patient developed cancer at the precise injection site of long-term insulin injection," is unwarranted. Most diabetics alternate sites of injections, and if she had been properly instructed on appropriate insulin administration, she would