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糖尿病患者足部马乔林溃疡所致鳞状细胞癌:病例研究

Squamous Cell Carcinoma From Marjolin's Ulcer of the Foot in a Diabetic Patient: Case Study.

作者信息

Cavaliere Raymond, Mercado Danielle M, Mani Malary

机构信息

Podiatric Surgeon, Department of Podiatric Surgery and Medicine, Mount Sinai Beth Israel Medical Center, New York, NY.

Podiatric Surgery Resident, Department of Podiatric Surgery and Medicine, Mount Sinai Beth Israel Medical Center, New York, NY.

出版信息

J Foot Ankle Surg. 2018 Jul-Aug;57(4):838-843. doi: 10.1053/j.jfas.2017.11.016. Epub 2018 Mar 2.

Abstract

Squamous cell carcinoma (SCC) has been commonly reported by foot and ankle specialists. Marjolin's ulcer is a malignancy that involves a posttraumatic scar or ulceration that can develop into SCC from chronic neuropathic pedal wounds, venous stasis, or decubitus ulcerations. Most Marjolin's ulcers are found in the lower extremity, specifically the feet, and it is twice as common in females as males. Biopsy of the tumor is the reference standard to diagnose SCC, and wide excision of SCC is the most common treatment option. The present case study describes an 83-year-old diabetic wheelchair-bound female who presented to the wound care clinic with a right heel nonhealing pressure ulceration. After biopsy and surgical excision, the patient was found to have SCC. This case was followed up for 5 years in which the patient had successful excision of the tumor with no recurrence. The clinical significance of our case study is to assist in the diagnosis, management, and prognosis of patients with SCC. In addition, this study has shown that adequate excision of the tumor margins and depth is necessary to prevent potential recurrence and metastasis.

摘要

足踝专科医生经常报告鳞状细胞癌(SCC)。马乔林溃疡是一种恶性肿瘤,它涉及创伤后瘢痕或溃疡,可由慢性神经性足部伤口、静脉淤滞或褥疮发展为鳞状细胞癌。大多数马乔林溃疡发生在下肢,特别是足部,女性的发病率是男性的两倍。肿瘤活检是诊断鳞状细胞癌的参考标准,广泛切除鳞状细胞癌是最常见的治疗选择。本病例研究描述了一名83岁的糖尿病女性,她坐在轮椅上,因右足跟部不愈合的压疮到伤口护理诊所就诊。活检和手术切除后,发现该患者患有鳞状细胞癌。该病例随访了5年,在此期间患者成功切除肿瘤且无复发。我们病例研究的临床意义在于协助鳞状细胞癌患者的诊断、管理和预后评估。此外,本研究表明,充分切除肿瘤边缘和深度对于预防潜在的复发和转移是必要的。

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