Marjolin's Ulcer of the Tibia With Pelvic Lymph Node Metastasis

Craig C Akoh; Justin Chang; Joseph Buckwalter

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Marjolin's Ulcer of the Tibia With Pelvic Lymph Node Metastasis

Journal article

Open access

Peer reviewed

Marjolin's Ulcer of the Tibia With Pelvic Lymph Node Metastasis

Craig C Akoh, Justin Chang and Joseph Buckwalter

The Iowa orthopaedic journal, Vol.37, pp.133-138

2017

PMCID: PMC5508282

PMID: 28852347

Appears in Diamond Open Access

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508282View

Published (Version of record) Open Access

Abstract

Marjolin's ulcer, a form of squamous cell carcinoma, is a rare complication of a chronic wound infection. To date, there have not been any detailed reports of lymphatic spread of Marjolin's ulcer from an extremity. This report describes a 44-year old male with a history of an open tibia fracture at age 15, who presented with chronic osteomyelitis, increasing bloody wound drainage, and an enlarging vascular exophytic masses in the region of drainage. Biopsy of the mass showed squamous cell carcinoma. Initial staging with computed tomography (CT) was negative for metastatic disease. Six months after undergoing a below-knee amputation (BKA), the patient developed an enlarged lymph node in the left inguinal area. His re-staging CT and biopsy of inguinal node confirmed the presence of metastatic squamous cell carcinoma. The patient was subsequently treated with inguinal node dissection and adjuvant radiation therapy. At 2.5 years follow-up, the patient remains disease-free. Our case illustrates the importance suspecting squamous cell carcinoma in patients with chronic infections and diligent follow up for patients with Marjolin's ulcers.

Adult

Amputation

Bone Neoplasms - etiology

Bone Neoplasms - pathology

Bone Neoplasms - surgery

Carcinoma, Squamous Cell - etiology

Carcinoma, Squamous Cell - pathology

Carcinoma, Squamous Cell - surgery

Humans

Lymphatic Metastasis - pathology

Male

Tibia - pathology

Tibia - surgery

Tibial Fractures - complications

Tibial Fractures - pathology

Tibial Fractures - surgery

Treatment Outcome

Details

Title: Subtitle: Marjolin's Ulcer of the Tibia With Pelvic Lymph Node Metastasis
Creators: Craig C Akoh - University of Iowa Hospitals and Clinics
Justin Chang - University of Iowa Hospitals and Clinics
Joseph Buckwalter - University of Iowa
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.37, pp.133-138
PMID: 28852347
PMCID: PMC5508282
NLM abbreviation: Iowa Orthop J
ISSN: 1541-5457
eISSN: 1555-1377
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
Language: English
Date published: 2017
Academic Unit: Orthopedics and Rehabilitation; Injury Prevention Research Center
Record Identifier: 9984303978502771

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