Concurrence of Marjolin’s Ulcer in the Lower Limb in a Patient with Idiopathic Multicentric Castleman Disease: A Case Report

Idiopathic multicentric Castleman disease (iMCD) is characterized by the benign proliferation of lymphoid cells in multiple regions. However, the co-occurrence of epithelial malignancy and idiopathic multicentric Castleman disease (iMCD) is rarely reported. Herein, we present a case of iMCD mimicking lymph nodal metastasis of Marjolin’s ulcer in the lower extremity. A 53-year-old male presented with an unhealed chronic ulcer on the left lower leg and foot accompanied by an enlarged mass in the left inguinal region. Intralesional biopsy was performed, and pathological examination showed squamous cell carcinoma (SCC). Imaged studies revealed left calcaneus bone invasion, and lymph nodal metastasis was suspected by the cancer TNM staging of T4N2M0 pre-operatively. The patient received below-knee amputation and lymph node dissection; intraoperative histological examination showed no lymphatic nodal malignancy and diagnosed the patient as having iMCD with lymphadenopathy. The patient recovered uneventfully and was referred to a hematologist for further treatment.

Staged Surgical Reconstruction With Skin Expansion of A Marjolin’s Ulcer With Better Recovery: a Case Report

Marjolin’s ulcers (MUs) are one of the most common tumors developed from non-healing wound with chronic inflammation or injury, specially burn scars, over many years. However, the therapy recommendations for MUs are not yet definitive. Here, we presented a case of 60-year-old man with a chronic non-healing infected wound related to MUs in the right knee. And, the wound made a better recovery after treatment with staged operation in combination with skin expansion.

HER2 and p53 Expression in Marjolin’s Ulcer

Background：Marjolin's ulcer is a malignant tumor that is different from other skin ulcers, and its pathogenesis is not yet clear. The diagnosis and prognosis of Marjolin's ulcer lack valuable marks on immunohistochemistry (IHC).Methods: In this study, we detected the expression of HER2 and p53 in Majorlin’s ulcer with immunohistochemistry, and retrospectively analyze the clinicopathological characteristics of Marjolin's ulcer samples.Results: Our results showed that no HER2 but p53 was detected in Majorlin’s Ulcer samples. Meanwhile, by statistic analysis we found that the positive expression rate of p53 in Majorlin’s Ulcer samples was associated with sex, course of disease, ulcer size, pathological type of ulcer canceration, and degree of tumor differentiation. Furthermore, we showed that the positive rate of p53 was proportional to the malignancy degree of Marjolin’s ulcer. Conclusions:Our results of this study will lay a foundation for diagnosis of Marjolin's ulcer and even prevention of Marjolin's ulcer progression

“Hurricane-like” Presentation of a Recurrent Marjolin's Ulcer in a Young Female

Marjolin’s ulcer (MU) with rapid progression and multiple distant metastases is rare. We report a case of an MU of the thigh developing in a postburn scar, which after successful R0 resection developed multiple bony and visceral metastasis to femur, vertebra, skull, lung, and liver within 3 months of excision. We highlight the “hurricane-like” recurrence in an MU, which is unusual for the metachronous disease. We stress that MUs, unlike conventional wisdom, need a thorough metastatic workup at presentation, and prognostication of a possible rapidly progressive course after surgery which may lead to grave prognosis and mortality.