Seven observations of Marjolin ulcer in chronic osteitis are reported in this study with the objective of evaluating their origin and the diagnostic and therapeutic problems encountered and comparing them to the data gathered from the literature. J Burn Care Rehabil, , 12, Conservative treatment with wide resection and flap cover was attempted in all seven patients. On x-ray, six patients presented signs of bone invasion with the appearance of evolving osteolysis at the fistula and skin lesions patients no. Indian J Cancer, , 33, Right, large, loculated, peripheral enhancing collection is observed in the subcutaneous tissue of the auricular region, posterior and anterosuperior to the external auditory canal and extending to the mastoid air cells and middle ear cavity.
In five cases, a local posterior sural fasciocutaneous flap with a distal pedicle skin flap was used in only two cases and associated with other flaps in three cases and in one patient, a local soleus and medial gastrocnemius muscle flap. J Bone Joint Surg Am , , 72, In the first century, Aurelius Cornelius Celsus was the first to report the development of a tumour in old burn scars and chronic nonhealing wounds. Carcinomatous degeneration of chronic osteomyelitic fistulae. Foot Ankle Int, , 25, The images of extended osteolysis can be related to the tumor extension but are also frequently found in cases of chronic bone infections Fig.
Axial computerized tomography of the temporal bone showed a mastoid abscess with bone destruction Figure 1.
In the literature, as in our series, Marjolin ulcers in chronic osteitis of the lower limb were clearly dominant [Sedlin and Fleming [ 3 S edlin E, F leming J: Squamous cell carcinoma is the most common variant, and while malignant degeneration usually takes a long time, it can develop acutely. The microanastomosed free flap of the latissimus dorsi is reserved for very extensive loss of substance.
However, acute malignant transformations to SCC do occur [ 51019 ].
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Figure 3 – The patient’s back after treatment. We marjloins seven cases. Case report and literature review. Malignant degeneration of chronic wound inflammation is a rare complication that almost always develops late.
Carcinoma squamo-cellulare di Marjolin
A new concept in the management of Marjolin’s ulcers. Fifteen years after spinal cord injury and 14 years after development of a sacral pressure ulcer in a paraplegic man, a squamous cell carcinoma was found on biopsy during surgical reconstruction of the pressure ulcer. Personal information regarding our website’s visitors, including their identity, revieew confidential. The patient refused the extensive surgery necessary to remove the infiltrating tumor, and the wound was closed with a latissimus dorsi flap.
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Marjolin’s ulcer in chronic osteomyelitis: seven cases and a review of the literature – EM|consulte
This treatment is therefore based on wide resection and the principles of surgical treatment of bone infections in continuous bone, associating excision, filling of the resection cavity, and skin flap cover [Lortat-Jacob [ 41 L ortat -J acob A: InDupuytren observed that de novo malignancy could arise in chronic wounds; he observed this phenomenon in a Belgian man who was treated for a cancer that developed from a scar sustained from a sulphuric acid burn [ 14 ].
In B, rotation of a local flap and a new skin graft 9 months postoperatively. Systematic biopsy of the lesions provided the diagnosis of malignant degeneration in six out of seven cases. Arch Phys Med Rehabil,67, Conservative surgery seems to be indicated for well-differentiated forms.
Marjolin’s ulcer is a malignant transformation ullcers traumatized or chronically inflamed cutaneous tissue that occurs after burns. This posterior sural fasciocutaneous flap with a distal pedicle can be used alone or associated with other flaps patients no. Conservative treatment was undertaken for all patients; it was based on wide resection of the lesions, resection of infectious lesions chronic osteitis lesions with soft tissue involvementand the skin flap cover.
The warning sign for these skin lesions under prolonged treatment was the onset of pain patients no. X and chronic wounds: In addition, adn patient should be informed that a complex conservative surgical program with resection, bone reconstruction, and grafted covering measures does not protect from recurrence that could require secondary amputation four cases out of seven in our experience.
Link to citation list in Scopus. Acta Derm Venereol,49, Fistula carcinoma arising from chronic osteomyelitis.
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Marjolin’s ulcers are aggressive and have a high rate of regional metastases. Access to Document Link to publication in Scopus.
Seris A, radiodermatitis of the treated area. Int Adv Surg Oncol,3, The wrong approach to tumors of the musculoskeletal system: The most commonly affected sites are the lower extremities, followed by the head and neck region and the trunk [ 111 ]. In B, macroscopic appearance.
Archives of Physical Medicine and Rehabilitation67 11 ,