Gigantski egzofitični Marjolinov ulkus na potkolenici posle sklopetarne povrede

  • Dejan Vulović University Clinical Center of Kragujevac, Center for Plastic Surgery, Kragujevac, Serbia
  • Vesna Stanković University Clinical Center of Kragujevac, Department of Pathology, Kragujevac, Serbia
  • Tatjana Vulović Šarenac University Clinical Center of Kragujevac, Clinic for Ophthalmology, Kragujevac, Serbia
  • Bojan Milošević University of Kragujevac, Faculty of Medical Sciences, Department of Surgery, Kragujevac, Serbia
  • Maja Vulović University of Kragujevac, Faculty of Medical Sciences, Department of Anatomy, Kragujevac, Serbia
  • Dragče Radovanović University of Kragujevac, Faculty of Medical Sciences, Department of Surgery, Kragujevac, Serbia
  • Marko Spasić University of Kragujevac, Faculty of Medical Sciences, Department of Surgery, Kragujevac, Serbia
DOI: https://doi.org/10.2298/VSP201110011V
Ključne reči: opekotine, karcinom, planocelularni, ožiljak, potkolenica, hirurgija, rekonstruktivna, procedure, rana vatrenim oružjem

Sažetak


Uvod. Marjolinov ulkus je maligni tumor kože koji se javlja na ožiljku ili na hroničnoj rani. Najčešće se javlja na ožiljku od opekotine. Najčešći tip tumora je skvamocelularni karcinom koji se javlja kod više od 90% slučajeva. Učestalost te maligne transformacije je 1–2%. Marjolinov ulkus je agresivniji od drugih karcinoma kože. Metoda izbora u lečenju je široka ekscizija. Recidivi su česti. Prikazujemo veliki egzofitični karcinom potkolenice, retku formu tumora u odnosu na veličinu i tip tumora, sa rezultatom nakon radikalne operacije i rekonstrukcije. Prikaz bolesnika. Prikazan je muškarac, star 52 godine, sa velikim egzofitičnim tumorom na levoj potkolenici. Tumor je bio lokalizovan na mestu prethodne sklopetarne povrede. Latentni period je iznosio 22 godine. Dimenzije tumora bile su 14 × 12 cm. Urađena je široka ekscizija (2 cm od ivica tumora) zajedno sa fascijom, a defekt je pokriven transplantatom delimične debljine kože, uzetim sa suprotne natkolenice. Histološki nalaz je pokazao da se radilo o dobro diferentovanom skvamocelularnom karcinomu. Nisu bile prisutne regionalne ili sistemske metastaze. Godinu dana posle operacije nije bilo recidiva tumora. Zaključak. Osnove lečenja Marjolinovog ulkusa su rana dijagnoza i široka ekscizija. Ekscizija treba da bude 2 cm od ivica tumora sa uklanjanjem duboke fascije. Preporuka je da se kod hroničnih rana periodično sprovode multiple biopsije. Stavovi oko stadijuma Marjolinovog ulkusa i disekcije limfnih žlezda nisu usaglašeni.

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Objavljeno
2022/09/21
Broj časopisa
Vol. 79 Br. 7 (2022): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika