Malignant transformation of leg ulcers: a retrospective study of 85 cases

Abstract

Malignant transformation of chronic leg ulcers of vascular origin is mainly encountered in elderly patients and manifests as an abnormally vegetating lesion, which may be occasionally bilateral. Malignant transformation usually occurs towards well-differentiated SCC and only exceptionally towards BCC. The high death rate, especially in metastatic cases, is at least partly due to delay in diagnosis. Surgery remains the treatment of choice. Leg amputation should be considered in the most extensive cases.

Malignant transformation of a chronic leg ulcer

“…The development of malignancy in a chronic leg ulcer has to be taken in consideration when a response to appropriate treatment is lacking for a longer period or exceeding granulation appears. Other symptoms like abnormal bleeding or unusual pain can confirm the suspicion of malignant transformation (2) as it occurred in the present case. Malignancy is described in ulcers of multifactorial etiology.…”

“…Prognosis of SCC on chronic leg ulcers is worse and has a higher metastatic rate when compared to sun‐induced SCC. Combemale et al (2) found an overall death rate of 37. 2% in 51 studied patients with SCC on chronic leg ulcer.…”

Initial presentation of stasis dermatitis mimicking solitary lesions: A previously unrecognized clinical scenario

“…5 Early diagnosis and appropriate treatment with compression therapy in combination with patient education can help prevent the development of painful and difficult-to-treat venous stasis ulcers and therefore decreases the risk of development of an ulcer-associated malignancy. [6][7][8][9] Herein we have demonstrated the rare occurrence of stasis dermatitis presenting as a solitary lesion as an initial manifestation before more typical clinically diagnostic changes. This early manifestation of stasis dermatitis accounts for 7% of all cases of stasis dermatitis in our clinical material.…”

“…As it is well-known that patients with a longstanding history of stasis dermatitis with associated ulcers are at risk of developing squamous cell carcinoma and rarely basal cell carcinoma, [7][8][9] dermatologists and dermatopathologists should also be aware that stasis dermatitis may clinically mimic neoplasms. Furthermore, the histopathology of stasis dermatitis has not been extensively described in the literature.…”

Carcinomes épidermoïdes (ou spinocellulaires)

“…Dans les cas d'ulcères de jambe d'origine vasculaire, le carcinome survient le plus souvent après de nombreuses années d'évolution de la plaie (en moyenne 25 ans) [5]. De même, les épidermolyses bulleuses héréditaires dystrophiques entraînent des ulcérations chroniques qui peuvent là favoriser la formation de carcinomes épidermoïdes.…”