MARJOLIN'S ULCER ON CHRONIC VENOUS ULCER: REVIEW OF THE LITERATURE AND A CASE REPORT

Introduction. Marjolin's ulcer is the malignant degeneration of a chronic skin lesion, which may be either inflammatory or traumatic. In most cases they occur on scars left from burns, but have also been reported in other types of injuries. The malignant degeneration of a chronic venous ulcer is exceptional. Case report. We report the case of an 80-year-old female who visited our surgery because of a venous ulcer she had had for 30 years and which had a yellowish-coloured surface with dark grey lobulated areas, irregular edges, an atrophic bottom and proliferations inside it, and covered 50% of the circumference of her leg. A pathology study showed that there was a squamous carcinoma on top of it. Treatment consisted in below-the-knee amputation of the limb. The post-operative period coursed in a satisfactory manner and the patient was discharged from hospital 12 days after the surgical intervention. Conclusions. When faced with a chronic venous ulcer with a bad appearance, with proliferations or tumoural growths or which does not progress favourably with the usual treatment, a possible malignant degeneration must be suspected and a biopsy sample must be obtained for study under the microscope. In these cases treatment necessarily consists in surgical exeresis, ensuring that prudent safety margins are left.