Consider Carcinoma Cuniculatum in Recurrent Foot Ulcer: A Case Report and Literature Review

Abstract

Carcinoma Cuniculatum is a variant of Squamous Cell Carcinoma, characterized by a slow growth with progressive crypt-like invasion of deep tissue. This tumor is frequently misdiagnosed as a benign skin lesion both clinically and histopatologically. The final diagnosis is often delayed as it requires a large sample biopsy. We report the case of a 67 year old patient which presented to us with a recurring chronic ulcer over a surgical scar of five years of evolution. Only after a wide resection of the chronic ulcer was it possible to achieve the correct diagnosis of this large and poorly evolving carcinoma. The subsequent reconstruction with a musculocutaneous gracilis free flap allowed the patient to walk again.