Development of spinocellular carcinoma in a long-lasting and therapy resistant venous ulcer - two case studies

While squamous cell carcinoma can primarily cause a leg ulcer, the malignant transformation of a primary venous leg ulcer to squamous cell carcinoma is rarer.

Two women with longstanding venous legs ulcer are presented. Both had diverse conservative, interventional and surgical therapies for both chronic venous insufficiency and their ulcers. These led to shortterm or intermittent closure of the ulcer with recurrence. In view of the only short intervals between the last surgical treatment and the again fulminant and fast progressive relapse, biopsies were taken from the ulcer base and border, revealing squamous cell carcinoma. After conservative surgical measures failed, both women required amputation.

In long-standing venous ulcers, malignant transformation should be considered especially in a fulminant or rapidly relapsing course after a surgical treatment. Biopsies should be taken to verify diagnosis and lead to correct therapy.