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Marjolin's ulcer arising from a laparostomy scar
P Yuste García1, P Villarejo Campos, J M Menéndez Rubio
1General and Digestive Surgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain. yustep@jazzfree.com
International Surgery
|September 14, 2006
Summary
Marjolin's ulcer, a rare squamous cell carcinoma, can develop from laparostomy scars. Early wound care and infection treatment are crucial for preventing this malignant transformation.
Area of Science:
- Oncology
- Dermatology
- Surgical Pathology
Background:
- Marjolin's ulcer is a malignant transformation of chronic scars, typically squamous cell carcinoma.
- It uncommonly presents in laparostomy scars, requiring surgical intervention.
Observation:
- A 49-year-old patient developed a 20-cm ulcer on a laparostomy scar 13 years post-treatment for necrohemorrhagic pancreatitis.
- The ulcer was diagnosed as invasive squamous cell carcinoma.
Findings:
- Surgical resection of the abdominal wall and transverse colectomy were performed due to cancer infiltration.
- Axillary lymphadenectomy was necessary for lymph node metastasis, indicating frequent nodal involvement in such cases.
Implications:
- Squamous cell carcinoma arising from Marjolin's ulcers, especially with lymph node metastasis, has a poor prognosis.
- Preventive measures include diligent wound care, timely skin grafting, and infection management to reduce Marjolin's ulcer risk.
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