Primary Invasive Squamous Cell Carcinoma of the Foot

Abstract

Malignant transformation of wounds is a rare complication that if missed can lead to loss of life or limb. This case report presents a rare invasive variant of squamous cell carcinoma presenting in the setting of a chronic wound complicated by osteomyelitis. This aggressive form of squamous cell carcinoma has a high growth rate and a high propensity for metastasis and recurrence. Early intervention greatly decreases the risk of metastasis and recurrence. We present the systematic evaluation and surgical management of an aggressive primary tumor occurring in the forefoot.

Squamous Cell Carcinoma Arising from Chronic Osteomyelitis in the Extremities: Treatment Approach and Oncological Outcomes—A Systematic Review of the Literature

“…The following articles were analyzed in this section [ 13 , 15 – 25 , 27 , 29 – 34 , 37 , 38 ] as they reported risk factors associated with worse outcomes. Although not statistically significant ( p =0.579), trauma-originated COM-derived SCC was associated with a lower metastasis rate (2/22, 9.09%) compared with other etiologies (1/7, 14.29%) ( Table 3 ).…”

“…COM is associated with persistent inflammation that can predispose to COM-derived SCC [10][11][12]. Identifying aggressive variants can provide a better guide for management and follow-up [13,44]. In this study, we described (1) demographic and clinical variables, and treatment modalities of these patients, (2) risk factors associated with worse outcomes, and (3) outcomes of treatment modalities used.…”

“…COM-related SCC has been intermittently reported in case reports, case series, or small retrospective studies that often fail to establish a true causal relationship between COM and SCC [ 13 , 15 – 38 ]. Additionally, available literature reviews [ 39 ] on the subject incorporate patient populations that mix specific data from COM-derived SCC with the broader condition of Marjolin ulcer, as well as COM that developed as a complication of a pre-existing SCC.…”

“…Incidence of SCC arising from COM ranges from 0.2-1.7% [10][11][12] and due to its aggressive nature, early aggressive treatment is recommended [13]. Definite treatment involves amputation or wide tumor excision, although the arrival of new immunotherapeutic agents is promising [10,14].…”

A Rare Case of Invasive Keratinizing Squamous Cell Carcinoma of the Foot

“…The conversion from an ulcer to malignancy is usually a slow process and the exact pathogenesis is yet to be definitively known. 2 It was Marjolin who, in 1827, first reported this process when he noted a malignant change in a chronic ulceration. cSCC is the most common secondary skin cancer noted to arise in chronic wounds, burn scars, trauma, and following radio necrosis.…”