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1.
Prensa méd. argent ; 106(9): 520-523, 20200000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1362772

ABSTRACT

Introducción: Las úlceras de Marjolin son neoplasias cutáneas que asientan sobre pieles afectadas por úlceras crónicas, quemaduras, cicatrices, estasis venosa o heridas cutáneas. Generalmente se diagnostica por medio de biopsias, siendo los carcinomas escamosos la variedad más frecuente. Existe escasa información sobre su desarrollo en heridas quirúrgicas abdominales previas, y aún menos casos reportados de su aparición sobre un defecto de la pared abdominal. Objetivo: Reporte de un caso de un paciente con antecedente de múltiples cirugías abdominales que desarrolló un carcinoma escamoso sobre cicatriz de laparotomía previa. Pacientes y Métodos: Presentación de un de un paciente masculino de 61 años, con antecedente de laparotomía exploradora, que consultó por una tumoración, de 6 meses de evolución, vegetante sobre eventración de mediana suprainfraumbilical. Se realiza exéresis de lesión en bloque de pared con enterectomia, anastomosis primaria y eventroplastia con malla de reemplazo. Cursa internación prolongada y con mala evolución, falleciendo al 77 día postoperatorio. Conclusión: Los carcinomas de células escamosas que se desarrollan sobre lesiones cutáneas previas presentan una agresividad mayor a aquellos desarrollados espontáneamente, tienen alto porcentaje de recidiva y metástasis asociadas. Se propone abordajes quirúrgicos radicales para su tratamiento, aun asi presentando una morbimortalidad elevada


Background: Marjolin ulcers are skin malignancies that appear on skin affected by chronic ulcers, burns, scars, venous stasis or skin wounds. They are generally diagnosed through a biopsy and the most frequent type is the squamous cell carcinoma. There is little information on its development in existing abdominal surgical wounds, and there are even fewer cases reported in relation to its appearance upon an abdominal wall defect. Objective: To report a case of a patient with a history of multiple abdominal surgeries who developed a squamous cell carcinoma in an existing laparotomy scar in association with an incisional hernia. Patient and Methods: A 61-year-old male patient, with history of an exploratory laparotomy in 1986, presents with a 6-month-old vegetating tumor upon a supra-infraumbilical median eventration. An excision of the lesion that included the abdominal wall and an associated enterectomy, primary anastomosis, and eventroplasty with replacement mesh was performed. During his prolonged hospital stay, he underwent with many medical intercurrences and even an additional surgery was needed. Eventually, the patient dies 77 days after the surgery. Conclusion: Squamous cell carcinomas that develop in existing skin lesions tend to be more aggressive than those that develop spontaneously. They have a high percentage of recurrence and associated metastases. Radical surgical approaches are suggested for its treatment, although it has a high morbidity and mortality rate.


Subject(s)
Humans , Male , Middle Aged , Recurrence , Skin Neoplasms/therapy , Skin Ulcer/surgery , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/therapy , Abdominal Wall/pathology , Neoplasm Metastasis/therapy
2.
Rev. bras. cir. plást ; 34(3): 399-404, jul.-sep. 2019. tab
Article in English, Portuguese | LILACS | ID: biblio-1047163

ABSTRACT

Introdução: A Úlcera de Marjolin é definida como a malignização de cicatrizes, geralmente, crônicas, decorrentes de diversos tipos de lesão, sendo mais comum lesões por queimaduras. Métodos: Foi realizado levantamento bibliográfico nas plataformas BVS, PubMed, SciELO e Cochrane, tendo como critério de inclusão estudos publicados nos últimos 5 anos, que envolvem a espécie humana, disponíveis na web nos idiomas inglês ou português. Resultados: Analisados um total de 31, dos quais apenas 6 compuseram a amostra final. Discussão: As úlceras de Marjolin são encontradas em cicatrizes antigas de queimaduras, podem ocorrer em qualquer local, sendo mais comuns em membros superiores e inferiores. O diagnóstico inicia-se com a suspeita clínica baseada em características das lesões: lesões ulcerativas crônicas que não cicatrizam, com bordas elevadas e endurecidas e odor desagradável, podendo apresentar descarga purulenta. Esse só pode ser efetivado, entretanto, por meio do histopatológico da lesão. O período de latência entre a injúria da lesão e a sua malignização é, em média, de 30 a 35 anos. O tratamento deve ser individualizado, uma vez que depende de diversos fatores. Contudo, considera-se o padrão ouro a excisão cirúrgica. Conclusão: O conhecimento dos profissionais de saúde acerca dessa condição faz-se imprescindível para o melhor prognóstico do paciente. De modo que possíveis casos de malignização não tenham o seu diagnóstico subestimado, permita a terapêutica adequada à minimização das recidivas, e medidas profiláticas sejam efetivadas, no que tange à prevenção da queimadura e à minoração de fatores de risco para a malignização.


Introduction: Marjolin's ulcer is defined as a malignancy within scars that is usually chronic and results from several lesion types, with burn injuries being the most common. Methods: A bibliographic survey was conducted of the Virtual Health Library, PubMed, Scientific Electronic Library Online, and Cochrane databases using the inclusion criteria of studies published in the last 5 years, human studies, and published in English or Portuguese. Results: A total of 31 studies were analyzed, of which only 6 were included in the final sample. Discussion: Marjolin's ulcer is found in old burn scars and can occur anywhere, but it is more common in the upper and lower limbs. The diagnosis begins with the clinical suspicion based on lesion characteristics: chronic unhealed ulcerative lesions with high and hardened edges, an unpleasant odor, and purulent discharge. However, the diagnosis can only be made histopathologically. The latency period between injury and malignancy is 30­35 years. Although treatment should be individualized since it depends on several factors, surgical excision is considered the gold standard. Conclusion: Knowledge about this condition is essential to better patient prognosis and prevent underestimation of possible cases of malignancy, allowing for appropriate therapy to minimize recurrence and enabling prophylactic measures to prevent burn injury and reduce risk factors for malignancy.


Subject(s)
Humans , Female , Adult , History, 21st Century , Skin Ulcer , Surgery, Plastic , Wound Healing , Burns , Burns, Electric , Carcinoma , Skin Ulcer/surgery , Surgery, Plastic/adverse effects , Surgery, Plastic/methods , Burns/surgery , Burns/complications , Carcinoma/surgery , Carcinoma/complications
3.
An. bras. dermatol ; 93(3): 443-446, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-949867

ABSTRACT

Abstract: A 37-year-old man complained of a refractory posterior malleolar ulceration on his left ankle. He was diagnosed with Werner syndrome according to the progeroid clinical features and genetic testing. To approach the ulceration, a free flow-through right anterolateral thigh perforator flap with anterolateral thigh cutaneous nerve was harvested. One year later, he was readmitted due to a new ulceration on his right ankle. We harvested the left anterolateral thigh perforator flap with anterolateral thigh cutaneous nerve to reconstruct the defect. After one more year of follow-up, there was no recurrence of ulcers, and the sensation of the flap recovered partially after 6 months. We conclude that free flow-through anterolateral thigh perforator flap is a feasible choice for the repair of foot ulcers in Werner syndrome.


Subject(s)
Humans , Male , Adult , Skin Ulcer/surgery , Werner Syndrome/surgery , Reconstructive Surgical Procedures/methods , Perforator Flap/transplantation , Werner Syndrome Helicase/genetics , Werner Syndrome/genetics , Lower Extremity , Mutation
4.
Rev. bras. cir. plást ; 28(1): 172-174, jan.-mar. 2013. ilus
Article in Portuguese | LILACS | ID: lil-687367

ABSTRACT

Úlcera de Marjolin é uma transformação maligna em tecido cutâneo cronicamente inflamado ou traumatizado, que ocorre especialmente após queimaduras. O carcinoma de células escamosas é o tipo histológico mais encontrado nas úlceras de Marjolin, seguido de carcinoma basocelular e melanoma maligno. Sarcomas em úlcera de Marjolin são raros, correspondendo a aproximadamente 5% dessas degenerações malignas. Neste artigo é descrito o caso de paciente do sexo feminino, vítima de queimadura há 42 anos, com grande ulceração em dorso. A biópsia dessa ulceração evidenciou sarcoma pleomórfico de alto grau em úlcera de Marjolin. A paciente foi submetida a ressecção da ulceração e enxerto de pele no local, seguidos de radioterapia e quimioterapia adjuvantes. Em 3 anos de seguimento, a paciente não apresentou recidiva da neoplasia. Úlceras de Marjolin são neoplasias malignas de comportamento agressivo, com alto índice de metástases regionais. A importância de seu entendimento está na necessidade de prevenção das mesmas, com o tratamento adequado dos pacientes queimados, evitando-se a cicatrização por segunda intenção. Sarcomas em úlcera de Marjolin são considerados raros, com poucos casos relatados na literatura, o que demonstra a importância deste relato.


Marjolin's ulcer is a malignant transformation of traumatized or chronically inflamed cutaneous tissue that occurs after burns. The most common histological type of carcinoma found in Marjolin's ulcers is squamous cell carcinoma, followed by basal cell carcinoma and malignant melanoma. Sarcomas in Marjolin's ulcers are rare, representing approximately 5% of these malignant degenerations. In this report, we describe the case of a female patient who was burned 42 years prior, with a large ulceration on her back. Biopsy of the ulceration showed a high-grade pleomorphic sarcoma in the Marjolin's ulcer. The patient underwent resection of the ulceration and a skin graft followed by radiation therapy and adjuvant chemotherapy. In 3 years of follow-up, the patient had no tumor recurrence. Marjolin's ulcers are aggressive and have a high rate of regional metastases. It is important that clinicians develop an understanding of their prevention by properly treating burns. Sarcomas in Marjolin's ulcers are rare and few cases have been reported in the literature, which demonstrates the importance of this report.


Subject(s)
Humans , Female , Middle Aged , History, 21st Century , Skin Ulcer , Surgery, Plastic , Burns , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Transplants , Histiocytoma, Malignant Fibrous , Melanoma , Skin Ulcer/surgery , Surgery, Plastic/methods , Burns/surgery , Burns/drug therapy , Burns/radiotherapy , Carcinoma, Basal Cell/physiopathology , Carcinoma, Squamous Cell/physiopathology , Transplants/surgery , Histiocytoma, Malignant Fibrous/surgery , Histiocytoma, Malignant Fibrous/physiopathology , Melanoma/physiopathology
5.
Dermatol. argent ; 17(1): 67-69, ene.-feb. 2011. ilus
Article in Spanish | LILACS | ID: lil-724126

ABSTRACT

Los carcinomas basocelulares gigantes (CBCG) son muy pocos frecuentes. Se los puede definir como aquellos mayores de 5 cm de diámetro. La mayoría de estos pacientes no refiere antecedentes de exposición crónica al sol ni presentan otros factores de riesgo conocidos. Existe en cambio una relación estrecha con situaciones de negligencia y tratamientos inadecuados. Se los encuentra frecuentemente en el tronco. Las lesiones mayores de 10 cm de diámetro tienen un alto riesgo de generar metástasis y en consecuencia producir la muerte. Presentamos una paciente de 92 años con dos masas tumorales en área malar y mejilla derecha que fue trtada quirúrgicamente, con buena evolución hasta los dos años de siguimiento posterior.


Giant basal cell carcinoma (GBCC) is an uncommon cutaneous tumor defined as a neoplasm largerthan 5 cm in diameter. Most of the affected patients neither present a chronic sun exposure historynor any significant risk factor.Negligence and inadequate treatments may undoubtedly contribute to this type of tumor.GBCC occurs must commonly on the trunk. Lesions greater than 10 cm in diameter have a highrate of metastasis.We report a 92-year-old woman with two such tumors located on the right zygomatic area andthe homolateral cheek. Surgical treatment was performed. After a follow up of two years no signsof dissemination or local recurrence have been detected.


Subject(s)
Humans , Female , Aged, 80 and over , Carcinoma, Basal Cell/surgery , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/pathology , Skin Neoplasms/surgery , Skin Neoplasms/diagnosis , Facial Neoplasms/pathology , Skin Ulcer/surgery , Skin Ulcer/pathology
6.
Dermatol. argent ; 17(1): 63-66, ene.-feb. 2011. ilus
Article in Spanish | LILACS | ID: lil-724128

ABSTRACT

Los carcinomas basocelulares gigantes (CBCG) son muy poco frecuentes. Se los puede definir como aquellos mayores de 5 cm de diámetro. La mayoría de estos pacientes no refiere antecedentes deexposición crónica al sol ni presentan otros factores de riesgo conocidos. Existe en cambio una relación estrecha con situaciones de negligencia y tratamientos inadecuados. Se los encuentra frecuentemente en el tronco. Las lesiones mayores de 10 cm de diámetro tienen un alto riesgo de generar metástasis y en consecuencia producir la muerte. Presentamos una paciente de 92 años con dos masas tumorales en área malar y mejilla derecha que fue tratada quirúrgicamente, con buena evolución hasta los dos años de seguimiento posterior.


CD4+ / CD56 malignancy is an extremely rare hematological neoplasm, which was recentlyshown to correspond to the so-called type 2 dendritic cell or plasmacytoid dendritic cell. Clinicalpresentation typically correspond to cutaneous nodules o tumors associated with lymphadenopathyor spleen enlargement or both, cytopenias and circulating malignant cells. The prognosis is rapidlyfatal in the absence of chemotherapy. Bone marrow transplantation is the best option available. Wepresent two new cases of this disease.


Subject(s)
Humans , Female , Aged , Carcinoma, Basal Cell/surgery , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/pathology , Skin Neoplasms/surgery , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Facial Neoplasms/pathology , Skin Ulcer/surgery , Skin Ulcer/pathology
7.
Rev. med. (Säo Paulo) ; 89(3/4): 147-151, jul.-dez. 2010. ilus
Article in Portuguese | LILACS | ID: lil-746907

ABSTRACT

Surgical treatment of the wounds includes a variety of procedures ranging from débridement to complex procedures such as use of free flaps using microsurgical techniques. Often surgery is important for closing of a chronic wound or a complex wound. These procedures include preoperative evaluation and proper decision on which type of coverage will be usedthat may be grafts, local flaps or free flaps...


O tratamento cirúrgico das feridas inclui uma série de procedimentos que vão desde o desbridamento até os procedimentos complexos como a utilização de retalhos livres utilizando técnicas microcirurgicas. Muitas vezes o tratamento cirúrgico é indispensável para o fechamento de uma ferida crônica ou uma ferida complexa. Estes procedimentos incluem a avaliação pré operatória adequada e a decisão de qual tipo de cobertura vai ser utilizado,podendo ser enxertos, retalhos locais ou retalhos livres...


Subject(s)
Humans , Wounds and Injuries/surgery , Wounds and Injuries/diagnosis , Surgical Flaps , Skin Ulcer/surgery
9.
Rev. paul. med ; 106(4): 197-200, jul.-ago. 1988. ilus, tab
Article in Portuguese | LILACS | ID: lil-69572

ABSTRACT

Säo apresentados seis casos de extravasamento acidental de adriamicina para o tecido celular subcutâneo nas áreas de infusäo, que evoluíram com úlceras de pele. As principais causas desse acidente säo revistas, bem como suas formas de prevençäo, tratamento precoce e as condutas recomendadas quando da ocorrência de necroses teciduais


Subject(s)
Child , Adult , Middle Aged , Humans , Male , Female , Doxorubicin/adverse effects , Extravasation of Diagnostic and Therapeutic Materials/complications , Skin Ulcer/chemically induced , Iatrogenic Disease , Skin Ulcer/surgery , Surgical Flaps
11.
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