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Marjolin's ulcer in a transplanted skin area after 50 years
Apresentação do caso
The case report is about a 68-year-old patient, with a history of extensive burns, which occurred 50 years ago in the right upper limb, chest and abdomen. He was submitted a skin transplant with plastic surgery reconstruction. The patient evolved with a large, ulcerated lesion, around 1 year, on the anterior chest wall and thoracoabdominal transition, on the same margin and location as the skin transplant, with a fast and progressive growth. The histopathological report is compatible with poorly differentiated squamous cell carcinoma. The patient underwent an extensive oncological resection and closure by second intention, with wound follow-up by the dressing committee and good clinical outcome.
Marjolin's ulcer is part of a group of neoplasms arising from a burn scar and is associated with the process of transformation of chronically inflamed or traumatized superficial tissues. Represents around 2 to 5% of all skin squamous cell carcinomas. It’s classified as acute when it occurs within 5 years of the burn, or chronic when after 5 years. The possibility of developing this type of injury in large burn patients, even after years of hyperthermic tissue injury, shows the importance of a watchful eye on this category of patients.The above-mentioned case describes an extremely rare incidence and little reported in the scientific literature, referring to the incidence of this type of neoplasm in a site affected by skin transplantation, even in the presence of graft compatibility with the patient's body.
Despite being rare, Marjolin's ulcer is a known complication in the healing of burns and, after reviewing the literature, no cases were found elucidating this development in transplanted skin grafts, which makes the report presented of great value for the better understanding of the pathology, since the reported patient had a positive outcome.
marjolin ulcer; skin transplatation; carcinoma
SARAH HULLIANE FREITAS PINHEIRO DE PAIVA, JADIVAN LEITE DE OLIVEIRA, LALYA CRISTINA SARMENTO DE FREITAS, KAIQUE TORRES FERNANDES, PRISCILA FERREIRA SOTO, LUIZ FERNANDO NUNES, NELSON JOSE JABOUR FIOD, ROBERTO ANDRE TORRES VASCONSCELOS, JULIANA VETORAZO ALVARENGA, JEAN CARLOS DA SILVA, MAURISTON RENAN MARTINS SILVA, DOUGLAS BARRADA RIBEIRO