- 期刊
Marjolin's Ulcer from a Chronic Venous Stasis Ulcer-A Case Report and A Review of Literature
慢性靜脈鬱血性潰瘍引起的馬喬林氏潰瘍－病例報告和文獻討論
摘要
背 景：馬喬林氏潰瘍（Marjolin's Ulcer）是一種少見的惡性癌症。文獻報告上大多是由燙傷造成的慢性疤痕組織或傷口所引起的。目的及目標：報告一位患者腿上長達十年以上的慢性靜脈鬱血性潰瘍所引起的馬喬林氏潰瘍症狀和其後的診斷與治療。同時以此例與現有文獻中其他相似病例報告進行病徵，診斷，和治療的比較和討論。材料與方法：療程包含清創，植皮，和最後的膝上截肢。斷層掃描和其他造影與臨床物理診斷都排除癌症的轉移。另外以不同的關鍵詞在PubMed文獻上進行類似病例的搜尋；標題，摘要，和参考資料篩選後再檢閱研究全文。結 果：目前文獻上少有記載慢性靜脈鬱血性潰瘍所引起馬喬林氏潰瘍的病例。大部份病例報告都至少有十年以上靜脈鬱血性潰瘍的病史。在病徵，診斷，和治療上並沒有一定的共識。從其他原因引起的下肢馬喬林氏潰瘍病例報告中提供了類似的診斷經驗和病徵。結 論：慢性靜脈鬱血性潰瘍引起馬喬林氏潰瘍的病例相當少見。我們的病人最後必須經由膝上截肢來治療他的疾病。文獻上可能的病因，診斷病徵，治療方針和預後都藉由此病例來進行研討。
關鍵字
無資料並列摘要
Background: Marjolin's ulcer denotes a rare type of carcinoma that often develops from a chronic burn scar or wound. Aim and Objectives: We report one rare case who developed Marjolin's ulcer from a chronic venous stasis ulcer of the leg after 10 years of latency. Extensive literature review of Marjolin's ulcer from venous stasis wound was performed to compare presentation, management, and outcome for this disease. Materials and Methods: Management included the initial wound debridement, skin grafting, and an eventual above knee amputation. Complete screening work-up was done to rule out any metastatic disease. PubMed searches with the key phrases: ＂Marjolin's ulcer＂ and ＂venous stasis＂ were entered. Titles, abstracts, and references were filtered and relevant full texts were reviewed. Results: Only case reports and small series have been reported specifically on Marjolin's ulcers from venous stasis ulcers. The latency of this disease is mostly 10 or more years after the initial development of venous stasis ulcer. No consensus on treatment, prognosis, and etiology has been found. Data on available studies regarding Marjolin's ulcers from the lower extremity were extracted to provide relevant diagnostic signs and symptoms. Conclusion: We presented a rare clinical case report of one patient who developed Marjolin's ulcer from a chronic venous stasis ulcer. Patient eventually received an above knee amputation due to his extensive disease. Possible etiologies, diagnostic criteria, treatment strategies, and prognoses are summarized after an extensive literature search.