Marjolin's ulcer arising from a laparostomy scar.
Marjolin's ulcer is the malignant transformation of a scar, usually as a squamous cell carcinoma. An uncommon presentation form is from a laparostomy scar. A 49-year-old patient that had a laparostomy during the treatment of a necrohemorrhagic pancreatitis in 1987 complained 13 years later of a 20-cm ulcer on the laparostomy scar. A resection of the abdominal wall including the ulcer and a segmental transverse colectomy were performed because of infiltration by an invasive squamous cell carcinoma. Ten months later, axillary lymphadenectomy was performed because of lymph node metastasis. Currently, the patient is free of disease. Lymph node infiltration is frequent in squamous cell carcinoma on Marjolin's ulcer and survival is not good. Prophylaxis of this disease includes meticulous care of wounds, with early skin grafts when required and treatment of infections.
Yuste García
P
P
General and Digestive Surgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain. yustep@jazzfree.com
Villarejo Campos
P
P
Menéndez Rubio
J M
JM
García Garciá
A
A
Pérez Viejo
E
E
Gambí Pisonero
D
D
Martinez Pueyo
J I
JI
Cruz Vigo
F
F
D001365:Axilla; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002908:Chronic Disease; D002921:Cicatrix / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007813:Laparotomy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000601:surgery; D011230:Precancerous Conditions / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014456:Ulcer / Q000209:etiology* / Q000601:surgery*