Lee M Y, Shin J C, Park C I, Rha D W, Sastry T K
Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, NC, USA.
Spinal Cord. 2004 Jul;42(7):431-4. doi: 10.1038/sj.sc.3101606.
This is a case report with literature review.
To describe a case of verrucous carcinoma, a rare histopathologic type, complicating a chronic pressure ulcer of duration less than 3 years.
The department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, USA.
A 24-year-old African-American male with long-standing incomplete paraplegia visited the wound clinic due to a pressure ulcer that had lasted for more than 1 year on the medial side of the right foot. Despite conservative management for almost 2 years after the initial visit, the ulcer is suspected to have undergone malignant transformation. Histological study led to the diagnosis of verrucous carcinoma that necessitated transtibial amputation on the right foot.
The carcinoma developed within 3 years, which was a relatively short time period for a pressure ulcer to have undergone malignant transformation. The diagnosis of verrucous carcinoma has never been reported as carcinoma complicating a pressure ulcer. No evidence of local recurrence or distant metastasis was seen in postoperative 10 months.
The possibility of malignant transformation should be kept in mind in cases of pressure ulcers that are unresponsive to treatment or that show morphological changes suspected to be cancerous. Furthermore, early detection and intervention increases the probability for successful outcome.
这是一篇伴有文献综述的病例报告。
描述一例疣状癌病例，这是一种罕见的组织病理学类型，并发于病程小于3年的慢性压疮。
美国北卡罗来纳大学教堂山分校物理医学与康复科。
一名24岁的非裔美国男性，患有长期不完全性截瘫，因右足内侧一处持续超过1年的压疮就诊于伤口诊所。初诊后尽管进行了近2年的保守治疗，但该溃疡疑似发生了恶性转化。组织学检查确诊为疣状癌，遂行右足经胫骨截肢术。
该癌症在3年内发展形成，对于压疮来说，这是一个相对较短的发生恶性转化的时间段。疣状癌作为压疮并发癌症的诊断此前从未有过报道。术后10个月未见局部复发或远处转移迹象。
对于治疗无反应或出现疑似癌变形态改变的压疮病例，应考虑其发生恶性转化的可能性。此外，早期检测和干预可提高成功治疗的几率。
