Malignant Transformation in Chronic Stage IV Sacral Pressure Ulcer: A Case of Marjolin Ulcer

2021 ◽  
Vol 33 (7) ◽  
pp. E53-E57
Author(s):  
Richard Simman ◽  
Fuad Abbas ◽  
Surendra Singh
Keyword(s):  
Pressure Ulcer ◽  
Poor Prognosis ◽  
Wound Care ◽  
Multidisciplinary Treatment ◽  
Stage Iv ◽  
Metastatic Potential ◽  
High Rate ◽  
Rare Type ◽  
Treatment Measures ◽  
Infectious Disease Specialists

A Marjolin ulcer (MU) is a rare type of skin cancer that most commonly occurs in burns and other traumatic scars, and it also may arise in chronic, poorly healing wounds. Typically, MU presents as a squamous cell carcinoma and has a high rate of metastasis resulting in poor prognosis. The mechanism of the aggressive and metastatic potential of MU has not been clearly defined. This malignancy is more common in patients who are elderly or immunocompromised and has also been characterized as a disease of economically developing nations in which health care resources are less abundant and treatment is delayed. Marjolin ulcer is a challenging, although rare, disease. This article presents a case of MU that arose in a chronic sacral pressure ulcer. This was a rare, multifactorial case; the patient’s many comorbidities required coordinated efforts by wound care, oncology, and infectious disease specialists. As seen in this case, MU can be insidious and may not become apparent until considerable progression has occurred. This article discusses the multidisciplinary treatment measures undertaken for this patient, the strategies for prophylaxis and early detection of MU, and ultimately, the poor prognosis of MU in such a scenario where diagnosis is delayed.

scholarly journals Spermatic Cord Lymphoma: A Case Report and Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Satoru Taguchi ◽  
Sayuri Takahashi ◽  
Katsuyuki Iida ◽  
Takashi Mizutani ◽  
Kazumi Yamaguchi ◽  
...  
Keyword(s):  
Spermatic Cord ◽  
Poor Prognosis ◽  
Early Stage ◽  
Treatment Options ◽  
Multidisciplinary Treatment ◽  
Stage Iv ◽  
Recommended Treatment ◽  
Testicular Lymphoma ◽  
Stage Iv Disease ◽  
Primary Testicular Lymphoma

Spermatic cord lymphoma is a rare lethal disease. It has a poor prognosis even in stage I or II disease when treated locally, therefore, multidisciplinary treatment for early stage is recommended. On the other hand, the treatment of choice for stage III or IV spermatic cord lymphoma remains to be determined. It is said that spermatic cord lymphoma is clinicopathologically similar to primary testicular lymphoma, therefore the treatment of spermatic cord lymphoma has often been determined by reference to the recommended treatment for primary testicular lymphoma. Here we report a new case of spermatic cord lymphoma, which was found in stage IV disease. We also review thirty-three cases which have been reported as spermatic cord lymphoma to date, and discuss treatment options.

scholarly journals Postoperative Recurrent Paraspinal Fibromatosis after Resection of Cervical Meningioma and Review of Literature

2021 ◽  
Author(s):  
Ankur Gupta ◽  
Nafisa S. Batta ◽  
Vikas Batra
Keyword(s):  
Rare Case ◽  
Multidisciplinary Treatment ◽  
Metastatic Potential ◽  
Female Child ◽  
High Rate ◽  
Review Of Literature ◽  
Resonance Imaging ◽  
Follow Up Study ◽  
First Case

AbstractThe extra-abdominal deep fibromatoses also called as desmoid tumor (DT) are rare musculoaponeurotic, histologically benign tumoral soft tissue lesions which are locally aggressive with high rate of recurrence and no metastatic potential. Here, we describe a rare case of postoperative paraspinal fibromatosis in female child after aciurgy of intraspinal cervical meningioma. The lesion was incidentally detected in routine follow-up study and showed significant interval growth over a period of 1 year. Surgical resection was performed after histopathological confirmation; however, recurrence was observed. Hitherto only seven cases of postoperative paraspinal fibromatosis have been reported in the literature. To the best of authors’ knowledge, this report is the first case of postoperative fibromatosis in cervical spine after resection of meningioma. The aim of the case report is to emphasize the clinical scenario for suspicion of fibromatosis, magnetic resonance imaging clues, and multidisciplinary treatment strategy which has shifted toward initial active surveillance.

scholarly journals Long-Term Survival due to Chemotherapy including Paclitaxel in a Patient with Metastatic Primary Splenic Angiosarcoma

2021 ◽  
pp. 910-918
Author(s):  
Masanori Takehara ◽  
Hiroshi Miyamoto ◽  
Yasuteru Fujino ◽  
Tetsu Tomonari ◽  
Tatsuya Taniguchi ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Median Overall Survival ◽  
Case Reports ◽  
Case Series ◽  
Stage Iv ◽  
Rare Type ◽  
Term Survival ◽  
Splenic Angiosarcoma ◽  
Line Chemotherapy

A primary splenic angiosarcoma is a rare type of soft tissue sarcoma and is associated with an extremely poor prognosis. In this study, we describe the case of a patient who was diagnosed with metastatic primary splenic angiosarcoma and survived for about 2 years. A 62-year-old female was referred to us for the treatment of splenic angiosarcoma with disseminated intravascular coagulation (DIC) and multiple liver and bone metastases. Paclitaxel therapy resulted in recovery from DIC and enabled her to continue sequential treatment through to sixth-line chemotherapy. We reviewed all splenic angiosarcoma case reports which were described as stage IV to date and compared with our case. From these data, we found that the median overall survival was 105 days, and the prognosis of splenic angiosarcoma of stage IV was worse than conventional case series. Splenectomy was performed in more patients than chemotherapy as a treatment. Moreover, various chemotherapeutic regimens were used. These data suggest that administering chemotherapy including paclitaxel to patients with splenic angiosarcoma might improve their prognosis.

scholarly journals FOXM1c is the predominant FOXM1 isoform expressed in cholangiocarcinoma that associated with metastatic potential and poor prognosis of patients

Heliyon ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. e06846
Author(s):  
Nathakan Klinhom-on ◽  
Wunchana Seubwai ◽  
Kanlayanee Sawanyawisuth ◽  
Worachart Lert-itthiporn ◽  
Sakda Waraasawapati ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Metastatic Potential

scholarly journals Hypoxia and the Tumor Microenvironment

2021 ◽  
Vol 20 ◽  
pp. 153303382110363
Author(s):  
Yue Li ◽  
Long Zhao ◽  
Xiao-Feng Li
Keyword(s):  
Immune Response ◽  
Cell Proliferation ◽  
Tumor Microenvironment ◽  
Tumor Progression ◽  
Poor Prognosis ◽  
Tumor Biology ◽  
Metastatic Potential ◽  
Tumor Detection ◽  
Tumor Aggressiveness

Hypoxia is an important feature of the tumor microenvironment, and is closely associated with cell proliferation, angiogenesis, metabolism and the tumor immune response. All these factors can further promote tumor progression, increase tumor aggressiveness, enhance tumor metastatic potential and lead to poor prognosis. In this review, these effects of hypoxia on tumor biology will be discussed, along with their significance for tumor detection and treatment.

scholarly journals Predictors of Survival in Adrenocortical Carcinoma: An Analysis From the National Cancer Database

2018 ◽  
Vol 103 (9) ◽  
pp. 3566-3573 ◽  
Author(s):  
Sri Harsha Tella ◽  
Anuhya Kommalapati ◽  
Subhashini Yaturu ◽  
Electron Kebebew
Keyword(s):  
Surgical Resection ◽  
Adrenocortical Carcinoma ◽  
Poor Prognosis ◽  
Stage Iv ◽  
Tumor Grade ◽  
Disease Stage ◽  
Survival Outcomes ◽  
National Cancer Database ◽  
Stage Iv Disease ◽  
Comorbidity Index

Abstract Context Adrenocortical carcinoma (ACC) is rare; knowledge about prognostic factors and survival outcomes is limited. Objective To describe predictors of survival and overall survival (OS) outcomes. Design and Patients Retrospective analysis of data from the National Cancer Database (NCDB) from 2004 to 2015 on 3185 patients with pathologically confirmed ACC. Main Outcome Measures Baseline description, survival outcomes, and predictors of survival were evaluated in patients with ACC. Results Median age at ACC diagnosis was 55 (range: 18 to 90) years; did not differ significantly by sex or stage of the disease at diagnosis. On multivariate analysis, increasing age, higher Charlson-Deyo comorbidity index score, high tumor grade, and no surgical therapy (all P < 0.0001); and stage IV disease (P = 0.002) and lymphadenectomy during surgery (P = 0.02) were associated with poor prognosis. Patients with stage I-III disease treated with surgical resection had significantly better median OS (63 vs 8 months; P < 0.001). In stage IV disease, better median OS occurred in patients treated with surgery (19 vs 6 months; P < 0.001), and postsurgical radiation (29 vs 10 months; P < 0.001) or chemotherapy (22 vs 13 months; P = 0.004). Conclusion OS varied with increasing age, higher comorbidity index, grade, and stage of ACC at presentation. There was improved survival with surgical resection of primary tumor, irrespective of disease stage; postsurgical chemotherapy or radiation was of benefit only in stage IV disease.

scholarly journals Prevention and treatment of pressure sore following spinal cord injury

2020 ◽  
Vol 63 (10) ◽  
pp. 623-632
Author(s):  
Myeong Ok Kim
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pressure Ulcer ◽  
Wound Care ◽  
Pressure Sore ◽  
Therapeutic Interventions ◽  
Advisory Panel ◽  
Pressure Sores ◽  
Cord Injury ◽  
Pressure Injury

Pressure sores or pressure injury is a serious complication of a spinal cord injury (SCI), representing a challenging problem for patients, their caregivers, and their physicians. Persons with SCI are vulnerable to pressure sores throughout their life. Pressure sores can potentially interfere with the physical, psychosocial, and overall quality of life. Outcomes directly depend on education and prevention along with conservative and surgical management. Therefore, it is very important to understand everything about pressure sores following SCI. This review covers epidemiology, cost, pathophysiology, risk factors, staging, evaluation tools, prevention, education, conservative wound care methods, surgical treatment, and future trends in wound healing related to post-SCI pressure sores. A change in nomenclature was adopted by the National Pressure Ulcer Advisory Panel in 2016, replacing “pressure ulcer”with “pressure injury.” New concepts of pressure injury staging, such as suspected deep tissue injuries and unstageable pressure injuries, were also introduced. A systematic evidence-based review of the prevention of and therapeutic interventions for pressure sores was also discussed.

scholarly journals Clinical efficacy of Thumari gel in the management of superficial non healing leg ulcers- A rare case report.

2017 ◽  
Vol 1 (1) ◽  
pp. 1-5
Author(s):  
Naresh Kumar Ghodela ◽  
Tukaram Dudhamal
Keyword(s):  
Lower Extremity ◽  
Venous Insufficiency ◽  
Treatment Approach ◽  
Wound Care ◽  
Multidisciplinary Treatment ◽  
Local Application ◽  
Rare Case Report ◽  
Arterial Insufficiency ◽  
Underlying Pathophysiology

Ulcers in lower extremity are generally caused by venous insufficiency, arterial insufficiency, and diabetic neuropathy. Inflammatory ulcers are also difficult to diagnose because of underlying pathophysiology rests on inflammation and immunologic phenomena. Definitive diagnosis and multidisciplinary treatment approach are needed to manage lower extremity ulcers. These ulcers may hamper the quality of life of patient. Here we reported a new case of post fracture of shaft of right tibia bone, presented with painful, hypertrophied, irregular shaped ulcer on anterior aspect of tibia gradually developing since 3 months. A male patient of 45 years old consulted to OPD with above complaint that was unable to bear weight on the effected leg (right limb). This case was managed with a local application of Thumari Gel and ulcers were almost healed within 6 weeks of wound care along with internal use of Ayurveda medicines. This case concluded that regular local application of Thumari Gel helpful in healing of chronic ulcer.

scholarly journals Analysis of epidemiological characteristics and surgical treatment of patients with pressure ulcer

2021 ◽  
pp. 93-93
Author(s):  
Dragana Petrovic-Popovic ◽  
Milan Stojicic ◽  
Maja Nikolic-Zivanovic
Keyword(s):  
Surgical Treatment ◽  
Pressure Ulcer ◽  
Traffic Accidents ◽  
Pressure Ulcers ◽  
Stage Iv ◽  
Clinical Center ◽  
Bony Prominence ◽  
The University ◽  
Epidemiological Characteristics ◽  
Reconstructive Methods

Introduction/Objective. A pressure ulcer is a localized injury to the skin and/or underlying tissue, usually over a bony prominence. It appears as a result of pressure or combination of pressure and shear. Pressure ulcers can be identified within a wide variety of patient subpopulations and a major role in their treatment plays epidemiological and etiological aspects. Methods. A retrospective study of data analysis included 72 patients with pressure ulcers that were hospitalized and surgically treated during a five-year period at the Clinic for Burns, Plastic and Reconstructive Surgery of the University Clinical Center of Serbia in Belgrade. Main data features used in the analysis were: gender, age, principal diseases, comorbidities and biochemical indicators of malnutrition. The patients' data was obtained from the existing patients? records. Additionally, the study analyzed the method of treating pressure ulcers, types of reconstructive methods in surgical treatment, as well as the incidence rate of partial osteotomy. Results. A total of 72 patients with pressure ulcers were included into this study with 54.7 ? 16.1 mean age. Three times more patients injured in traffic accidents were male (75% vs. 25%), while the most of the patients with multiple sclerosis were female (85.7%). More than 95% of patients who had pressure ulcers of III or IV stage were treated surgically with a reconstructive method of transposition or rotation myocutaneous flap. The patient with pressure ulcer of stage IV was usually treated with partial osteotomy. Conclusion. A surgical reconstructive treatment with fasciocutaneous and myocutanaeous flaps represents a gold standard for treating patients with pressure ulcers. These procedures provide reconstruction with adequate flap coverage and obliteration of dead space with well-vascularized tissue but with necessity of further implementation of antidecubitus measures.

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