Marjolin's Ulcer with well-differentiated Squamous Cell Carcinoma
Basic Info
Doctor’s Name: Dr. Leena Jain
Clinic/ Hospital Name: Plastikos Clinic, Shushrusha Hospital, Dadar West
Patient’s Name: Mr. J
Patient’s Age: 53
Gender: Male
Patient Background
Mr. J, a 53-year-old male diabetic patient, had a long-standing history of skin issues. About 15 years ago, he underwent an injection treatment for a white patch on the back of his right hand. Unfortunately, the injection led to a severe infection and the loss of his thumb. Since that incident, Mr. J developed a persistent, non-healing ulcer on the back of his right hand, which had been resistant to treatment and continued to worsen over time.
Symptoms
The patient presented with a non-healing ulcer on the back of his right hand that was characterized by spontaneous bleeding and increased pain. The ulcer had become increasingly problematic, leading Mr. J to seek surgical intervention after years of discomfort.
Diagnostic Method
Dr. Leena Jain, an experienced plastic and reconstructive surgeon, conducted a detailed clinical evaluation followed by an excision biopsy. The biopsy confirmed the diagnosis of Marjolin’s ulcer with well-differentiated squamous cell carcinoma (SCC), a malignant tumor that can arise from long-standing, chronic wounds, often resulting from burns or infections.
Disease Diagnosed
Diagnosis: Marjolin's Ulcer with well-differentiated squamous cell carcinoma on the right hand.
Marjolin’s ulcer is a rare but serious complication that can arise from chronic wounds, and it is important to treat it as early as possible to prevent the spread of cancer. Dr. Jain’s expertise in reconstructive microsurgery allowed for an efficient and effective treatment plan that maximized the functional and aesthetic recovery for Mr. J.
Treatment Plan
Dr. Jain developed a two-stage surgical approach to treat the Marjolin’s ulcer and achieve optimal recovery for Mr. J:
Stage 1: Wide Local Excision and Biopsy with VAC Dressing
Dr. Jain performed a wide local excision to remove the malignant tissue surrounding the ulcer. This step aimed to ensure complete removal of the cancerous cells, thereby reducing the risk of recurrence.
A VAC (Vacuum-Assisted Closure) dressing was applied to promote healing and prevent infection at the surgical site while enhancing tissue growth.
Stage 2: Free Suprafascial Thin Anterolateral Thigh Flap
After a week of VAC dressing, Dr. Jain performed a free suprafascial thin anterolateral thigh flap, a microsurgical technique, to cover the defect left by the excision. This flap, taken from the thigh, was used to restore the damaged tissue and ensure proper coverage of the wound.
Post Surgery Guidelines
Post-surgery, Dr. Jain provided detailed recovery guidelines to ensure the best possible healing:
Finger and Wrist Exercises: After the plaster was removed, Mr. J was advised to start gentle finger and wrist exercises to prevent stiffness and promote joint mobility.
Suture Removal: Once the sutures were removed, Mr. J was encouraged to perform a full range of hand movements to maintain flexibility and regain normal hand functionality.
Dr. Jain ensured that all follow-up care was closely monitored to avoid complications, with regular check-ups to assess flap integration and wound healing.
Outcome
The surgical procedure achieved remarkable results, with Mr. J’s flap settling well without any complications. Over a period of 10-12 years post-surgery, the wound healed completely, and there were no signs of recurrence of the cancer in the treated area. Mr. J regained full hand functionality, which significantly improved his quality of life.
Long-Term Expectation
No recurrence of cancer: .He may need radiation to ensure no recurrence.
Complete restoration of hand activity and function, with the patient able to resume daily tasks without limitations.
Dr. Jain’s precision in the surgical technique and her commitment to patient care ensured a long-term, favorable outcome for Mr. J.
Patient Feedback
Mr. J expressed immense satisfaction with the results, stating, “I’m really happy with the outcome of the surgery. I’ve regained full range of motion in my hand and can carry out my daily activities without any issues.being ulcer free is unbelievable for me and my hand feels so free without tightness of pevious scars. The flap has blendd so well with the rest of my hand, and I’m thankful to Dr. Leena Jain for her expert care.”
Conclusion
Dr. Leena Jain’s advanced expertise in plastic surgery in Mumbai helped Mr. J overcome the challenges of a chronic wound and cancerous growth, restoring both the appearance and function of his hand. Her precise surgical techniques, paired with her compassionate patient care, allowed for a successful outcome that continues to benefit the patient’s health and well-being.
If you or someone you know is dealing with non-healing ulcers, cancerous growths, or other reconstructive concerns, Dr. Leena Jain’s specialized skills in microsurgery and plastic surgery could provide the solution.
Contact Dr. Leena Jain for a consultation today!
Disclaimer: This case is for educational purposes only; results may differ for each patient.