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马乔林溃疡:在因顽固性骨盆骨髓炎行半骨盆切除术时偶然诊断出鳞状细胞癌。

Marjolin's ulcer: incidental diagnosis of squamous cell carcinoma on hemipelvectomy for recalcitrant pelvic osteomyelitis.

作者信息

Lack William, McKinley Todd

出版信息

Iowa Orthop J. 2010;30:174-6.

Abstract

Hemipelvectomy is a radical surgical procedure reserved for particularly devastating pathology including recalcitrant pelvic osteomyelitis. We describe the incidental diagnosis of a metastatic squamous cell carcinoma by pathology after hemipelvectomy for pelvic osteomyelitis. This tumor was located deep within the chronic wound and deemed to be a Marjolin's ulcer (malignant transformation within a chronic wound). There are multiple reports and case series describing hemipelvectomy for tumor or infection, as well as one case report of a tumor arising years after successful surgical treatment of a chronic decubitus ulcer, but we were unable to find any describing the diagnosis of a Marjolin's ulcer at pathology following hemipelvectomy for osteomyelitis. This case demonstrates the diagnostic dilemma of malignant transformation within a chronic wound and is an opportunity to highlight the interventions necessary to prevent such progression.

摘要

半骨盆切除术是一种根治性手术,用于治疗包括顽固性骨盆骨髓炎在内的特别严重的病症。我们描述了一例在因骨盆骨髓炎行半骨盆切除术后经病理检查意外诊断出转移性鳞状细胞癌的病例。该肿瘤位于慢性伤口深处,被认为是Marjolin溃疡(慢性伤口内的恶性转化)。有多项报告和病例系列描述了因肿瘤或感染行半骨盆切除术,以及一例在成功手术治疗慢性褥疮多年后出现肿瘤的病例报告,但我们未能找到任何关于因骨髓炎行半骨盆切除术后病理诊断为Marjolin溃疡的描述。该病例展示了慢性伤口内恶性转化的诊断困境,也是一个强调预防此类进展所需干预措施的机会。

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本文引用的文献

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Hemipelvectomy and reconstruction in a patient with advanced Marjolin's ulcer: a case report.
Int J Low Extrem Wounds. 2009 Sep;8(3):162-4. doi: 10.1177/1534764609344130.
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Marjolin's ulcer: modern analysis of an ancient problem.马乔林溃疡:对一个古老问题的现代分析
Plast Reconstr Surg. 2009 Jan;123(1):184-191. doi: 10.1097/PRS.0b013e3181904d86.
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Hemipelvic amputations for recalcitrant pelvic osteomyelitis.针对顽固性骨盆骨髓炎的半骨盆截肢术。
Injury. 2008 Apr;39(4):411-8. doi: 10.1016/j.injury.2007.12.002. Epub 2008 Mar 5.
5
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Spinal Cord. 2008 Mar;46(3):239-40. doi: 10.1038/sj.sc.3102090. Epub 2007 Jul 3.
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Marjolin's ulcer in patients with spinal cord injury.脊髓损伤患者的马乔林溃疡
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