Malignização de úlcera de longa duração em paciente com sequela de hanseníase: um relato de caso
Malignant transformation of a long-term ulcer in a patient with leprosy sequelae: a case report
Aline Gabriele Etur dos Santos; Antônio Augusto Moreira Neto
Resumo
Palavras-chave
Abstract
Marjolin’s ulcer (MU) is a rare condition defined as a malignant skin tumor arising from chronic wounds and inflammation. The most common histological findings in MUs are squamous cell carcinomas (SCC) (or spinocellular carcinomas [SPC]), such as basal cell carcinomas (BCC) and malignant melanomas (MM). The aim of this study is to report the case of a patient with sequelae of leprosy who presented malignant transformation in a long-standing ulcer on the right leg, thereby contributing to understanding of the progression and significance of early diagnosis of MU. The MU was diagnosed by incisional biopsy of the lesion and upon obtaining a positive result the patient was referred to an oncology service. Treatment of MU is multidisciplinary and surgical excision is the first therapeutic option. Proper management and surveillance of chronic ulcers by the healthcare team are necessary for early recognition of MU.
Keywords
Referências
1 Carlson AR, Nomellini V, Neuman HB. Importance of high clinical suspicion in diagnosing a Marjolin’s ulcer with an unusual presentation. Am Surg. 2014;80(2):E61-2.
2 Dinato SLM, Nóvoa EG, Dinato MM, Almeida JRP, Romiti N. Case for diagnosis. An Bras Dermatol. 2011;86(3):601-2.
3 Iqbal FM, Sinha Y, Jaffe W. Marjolin’s ulcer: a rare entity with a call for early diagnosis. BMJ Case Rep. 2015;2015:bcr2014208176.
4 Thio D, Clarkson JHW, Misra A, Srivastava S. Malignant change after 18 months in a lower limb ulcer: acute Marjolin’s revisited. Br J Plast Surg. 2003;56(8):825-8.
5 Sabin SR, Goldstein G, Rosenthal HG, Haynes KK. Aggressive squamous cell carcinoma originating as a Marjolin’s ulcer. Dermatol Surg. 2004;30(2 Pt 1):229-30.
6 Shah M, Crane JS. Marjolin 's Ulcer [Internet]. StatPearls; 2023 [citado 2024 maio 20].
7 Instituto Nacional de Câncer José Alencar Gomes da Silva. Câncer de pele não melanoma [Internet]. Rio de Janeiro: INCA; 2022 [citado 2024 maio 20].
8 Yuste PG, Villarejo PC, Menéndez JMR, et al. Marjolin’s ulcer arising from a laparotomy scar. Int Surg. 2006;91(4):207-10. PMid:16967681.
9 Leonardi DF, Oliveira DS, Franzoi MA. Úlcera de Marjolin em cicatriz de queimadura: revisão de literatura. Rev Bras de Queimaduras. 2013;12(1):49-52.
10 Lee SH, Shin MS, Kim HS, et al. Somatic mutations of Fas (Apo-1/CD95) gene in cutaneous squamous cell carcinoma arising from a burn scar. J Invest Dermatol. 2000;114(1):122-6.
11 Harland DL, Robinson WA, Franklin WA. Deletion of the p53 gene in a patient with aggressive burn scar carcinoma. J Trauma. 1997;42(1):104-7.
12 Lawrence EA. Carcinoma arising in the scars of thermal burns, with special reference to the influence of the age at burn on the length of the induction period. Surg Gynecol Obstet. 1952;95(5):579-88. PMid:12995250.
13 Venkatswami S, Anandan S, Krishna N, Narayanan CD. Squamous cell carcinoma masquerading as a trophic ulcer in a patient with Hansen’s disease. Int J Low Extrem Wounds. 2010;9(4):163-5.
Submetido em:
04/04/2024
Aceito em:
04/06/2024