Squamous cell carcinoma complicating chronic venous leg ulceration: a study of the histopathology, course and survival in 25 patients

Abstract

We have studied 25 cases of squamous cell carcinoma in chronic venous leg ulcers. Twenty-three of the patients were dead and two were alive. The mean age at cancer diagnosis was 78.5 years. The median survival was 1 year. Eleven tumours were well-differentiated, 10 moderately and four poorly. All patients with a poorly differentiated tumour died within a year. Metastases were certain in eight cases. The disease was lethal in 10 cases which included all poorly differentiated tumours. The survival of the study group was significantly shortened compared with a control group of patients with lower limb non-melanoma skin cancer (n = 433) from the Swedish Cancer Registry (P = 0.0084). When diagnosed, squamous cell carcinoma in chronic leg ulcers merits a thorough investigation of the degree of differentiation and spread. Assertive treatment is indicated as poorly differentiated tumours and some moderately differentiated tumours may be fatal.

Marjolin's Ulcers as a Consequence of Chronic Venous Ulcers and Chronic Skin Injury - Case Reports

“…Similar to other authors (9,14), we think that the treatment of Marjolin's ulcers should not include radiotherapy. This type of treatment does not guarantee effective eradication of the tumour and may be the cause of formation of a chronic wound (9).…”

“…They analysed specimens from the neoplastic lesions and defined the cancer grading once again. They found that while the patients had venous ulceration diagnosed on average at the age of 56.4 and cancer in the ulceration diagnosed on average at the age of 78.5, their survival median was about 1 year and the prognosis was related to the degree of histological malignancy of the neoplasm (9,12).…”

“…Their shape may adopt the form of a wart, erosion, nodule or a cauliflower-like form (3). Although research says that the average time span between the formation of ulceration and cancer diagnosis is about 25 years and no cancer has been diagnosed in ulcerations aged less than 3 years (2, 10, 11), each ulceration that does not improve, worsens or is atypical should be an indication for a biopsy (9). Early diagnosis is very important.…”

“…This type of treatment does not guarantee effective eradication of the tumour and may be the cause of formation of a chronic wound (9). Patient H.M., due to her initial disagreement to operative treatment, had radiotherapy, but without success.…”

An Unusual Klebsiella Septic Bursitis Mimicking a Soft Tissue Tumor

“…Although simple bursitis has a well-defined capsule, the lesion in chronic bursitis can appear less well defined due to the inflammation of the surrounding tissues (11,13). Simple prepatellar bursitis, also known as housemaid s knee , is described as an excessive amount of fluid in the bursal space due to inflammation (10,14). and it is easily diagnosed clinically and by MRI with the typical T1 and T2-weighted of fluid within the bursa.…”