Marjolin’s ulcer due to congenital myelomeningocele

Sixty-seven year-old male with congenital myelomeningocele and sacral fistulas of 30 years of evolution. He was admitted for fever, oedema of the left leg, sacrococcygeal ulcer with ischiorectal fistulae (Fig. 1), left osteomyelitis (Fig. 2, arrow) and adenopathic inguinal blocks (Fig. 2, asterisks).

Fig. 1

Fig. 2

After debridement and biopsies, a diagnosis of well-differentiated infiltrating squamous neoplasm was made, and by computed tomography, bone, lung and liver metastases, and the patient died on admission.

Marjolin’s ulcer, or malignant degeneration of areas of chronic inflammation, consists of rapidly evolving neoplasms with a poor prognosis present in .5% of patients with spinal cord injuries. Surgery with curative intent is rare and consists of extensive soft tissue and musculoskeletal resections.

Conflict of interests

There are no financial, professional or personal conflicts of interests of any kind.