頁籤選單縮合
題 名 | Marjolin's Ulcer Arising in a Burn Scar=燙傷疤痕處的Marjolin潰瘍 |
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作 者 | 許世人; 蕭弘道; 董光義; 歐聖運; 曾岐元; | 書刊名 | 中華民國整形外科醫學會雜誌 |
卷 期 | 9:3 2000.09[民89.09] |
頁 次 | 頁200-206 |
分類號 | 416.141 |
關鍵詞 | 燙傷疤痕; Marjolin潰瘍; 惡性潰瘍; Marjolin's ulcer; Burn scar carcinoma; |
語 文 | 英文(English) |
中文摘要 | Marjolin潰瘍已經成為皮膚,竇和疤痕,尤其是燙傷疤痕,發生惡性潰瘍的同義詞。這是一個越來越罕見的疾病。與日光引起的上皮細胞癌比起來,疤痕癌的病程不易早期診斷,較易進展和轉移,癒後也較差。本院報告一位34歲男性病人,在燙傷25年後於右側背部的一處疤痕,演變成以反覆發作的慢性潰瘍為表現的扁平上皮細胞癌。在第一次發生潰瘍時,他接受補皮的治療,癒合良好。病理報告是發炎及疤痕生成。4年後,慢性潰瘍復發。於術中的冷凍病理切片證實是扁平上皮細胞癌,於是病人接受距病灶邊緣2公分的進一步切除和補皮,術後追綜12個月無復發跡象或轉移。因此,本文的目的,即是要揭示以下兩點的重要性:1.不論是病人或醫師都要知道惡性潰瘍的可能性,對於任何發生在燙傷疤痕上的慢性潰瘍都要提高警覺,積極治療和補皮。2.因為癌細胞經常只存在於一部分的潰瘍邊緣,因此,若非整個切除送病理切片檢查,很可能會被誤診。唯有如此,才能掌握機先,給予早期的診斷和治療,以得到較好的癒後。在此我們報告一例較常見的慢性型Marjolin潰瘍的成功診治的經驗並做一文獻上的回顧。 |
英文摘要 | The term Marjolin's ulcer is now synonymous with malignant transformation of chronic ulcers of the skin, sinuses, scar tissue, and especially burn scars. It is a rare disease, is usually at an advanced stage at initial presentation, is more progressive, and ultimately has a poor prognosis. We present a 34-year-old man with squamous cell carcinoma (SCC) arising from a recurrent chronic ulcer on the right side of his back from a burn scar due to a flame burn 25 years ago. At the first episode of chronic ulcer, he had received splint thickness skin graft (STSG) and the pathological report was inflammation and scar formation. Unfortunately, a chronic ulcer recurred 4 year later. The intraoperative frozen resection reported the lesion was SCC. We made a wide excision with surgical margin of 2 cm and covered with STSG. The patient is now free of disease 12 months after excision. Our purpose is to illustrate the importance of (1) keeping alert (both patients and physicians) to chronic ulcerated burn scars to obtain an early diagnosis and (2) performing excisional biopsies rather than small biopsies to avoid false-negative findings, we present this case with a review of the literatures pertaining to burn scar carcinoma. |
本系統中英文摘要資訊取自各篇刊載內容。