Criteria:
(1) The skin must previously have been normal.
(2) Adequate and authenticated trauma must have occurred.
(3) The tumor should be a primary neoplasm consistent with tissues at the site. The possibility of a metastasis to the site must be excluded.
(4) The carcinoma must originate from the exact point of injury.
(5) A reasonable time interval between the trauma and the first appearance of the carcinoma must be present.
(6) There must be a continuity of physical signs from the traumatic event to the appearance of the carcinoma.
Issues:
(1) A single episode of trauma may be sufficient.
(2) Tumors may metastasize to sites of increased vascularity like sites of trauma or fracture. I have seen lung cancer present as a metastasis to a fractured thumb.
(3) The latency period may range from a few months to 35 years or more. Thiem proposed a minimum period of 3 weeks in 1909, but that seems too short a period to me.
(4) It would be essential to exclude chemical toxic injury to the site and radiation injury.
(5) Authentication of the original trauma is best done by a physician after a complete examination.
