Letter to the Editor

Radical Surgical Treatment for Marjolin Ulcer Occurring after Chronic Osteomyelitis

Authors: Livia S. Smidt, MD, Luis Felipe S. Smidt, MS, Maria Bernadete F. Chedid, MD, PhD, Caren S. Bavaresco, MSc, Marcio F. Chedid, MD

Abstract

A 56-year-old man with a 40-year history of nonhealing osteomyelitis of the right leg presented with complaints of increasing pain. Previous treatment for the infection included unsuccessful surgical treatment and systemic antibiotic therapy. The lesion was ulcerative, with infiltration of the margins (Fig. 1). Bilateral chronic venous insufficiency was present. Local biopsy revealed the presence of a squamous cell carcinoma. Palpable lymph nodes were found in the groin. Excisional biopsy of the enlarged inguinal nodes revealed only reactional response. Computed tomography of the thorax revealed enlarged lymph nodes at the mediastinum. Mediastinoscopy was done, and biopsy did not show malignant cells. No abnormality was found on abdominal ultrasonography. The patient underwent a supracondylar leg amputation. Postoperative course was uneventful. There was no evidence of tumor recurrence one year after the procedure.

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