Peterson Richard, Sardi Armando
Department of Surgery, St. Agnes HealthCare, Baltimore, Maryland 21229, USA.
Am Surg. 2004 Jun;70(6):507-11.
Development of squamous cell carcinoma (Marjolin's ulcer), a well-known and rare complication of chronic ulcers, sinuses, chronic osteomyelitis and burn scars, may complicate chronic pressure ulcers. For several years, reports have suggested these cancers (pressure sore carcinoma, PSC) are highly fatal and aggressive, unlike other Marjolin's ulcers. A 39-year-old male, paraparetic from spina bifida, with history of chronic pressure sores and osteomyelitis of the pelvic bones underwent multiple resections. A descending colostomy was performed to avoid soiling of the perineum and decubitus ulcers. He developed squamous cell carcinoma in multiple pelvic areas. He was dependent on two daily visits by home care nurses for wound care. After negative workup for metastasis, as his only chance for cure he was offered hemicorporectomy, which was performed at the L4-L5 disc level. A prosthesis was applied 1 month after the surgery. As of November 2003, he remains disease-free after 7 years (90 months) from initial surgery. He is employed as a computer programmer, is self-dependent, and also drives. Aggressive treatment in select patients with PSC is essential and can lead to long-term disease control and increase in overall quality of life.
鳞状细胞癌（马乔林溃疡）是慢性溃疡、窦道、慢性骨髓炎和烧伤瘢痕的一种广为人知但罕见的并发症，慢性压疮也可能并发该病。多年来，有报告指出，与其他马乔林溃疡不同，这些癌症（压疮癌，PSC）具有高度致命性且侵袭性强。一名39岁男性，因脊柱裂导致双下肢轻瘫，有慢性压疮和骨盆骨髓炎病史，接受了多次切除术。为避免会阴部和褥疮污染，进行了降结肠造口术。他在多个盆腔区域发生了鳞状细胞癌。他依赖家庭护理护士每天两次上门进行伤口护理。在排除转移的检查结果为阴性后，作为他唯一的治愈机会，为他实施了半体切除术，手术在L4-L5椎间盘水平进行。术后1个月安装了假体。截至2003年11月，自初次手术7年（90个月）后他仍无疾病。他受雇为计算机程序员，生活自理，还能开车。对部分PSC患者进行积极治疗至关重要，可实现长期疾病控制并提高总体生活质量。
