Journal of Trauma and Injury

  • 제20권1호
  • /
  • Pages.52-56
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  • 2007
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

화상 후 두피에 생긴 편평 상피세포 종양에 대한 증례 보고 - 증례보고 -

Surgical Treatment of Squamous cell Carcinomas Arising in Scalp Burn Wounds - Two Case Reports -

  • 김강산 (한림대학교 의과대학 신경외과학교실) ;
  • 황형식 (한림대학교 의과대학 신경외과학교실) ;
  • 권흠대 (한림대학교 의과대학 신경외과학교실) ;
  • 문승명 (한림대학교 의과대학 신경외과학교실) ;
  • 오석준 (한림대학교 의과대학 성형외과학교실) ;
  • 최선길 (한림대학교 의과대학 신경외과학교실)
  • Kim, Kang San (Department of Neurosurgery, College of Medicine, Hallym University) ;
  • Hwang, Hyung Sik (Department of Neurosurgery, College of Medicine, Hallym University) ;
  • Kwon, Heum Dai (Department of Neurosurgery, College of Medicine, Hallym University) ;
  • Moon, Seung Myung (Department of Neurosurgery, College of Medicine, Hallym University) ;
  • Oh, Suk Jun (Department of Plastic Surgery, College of Medicine, Hallym University) ;
  • Choi, Sun Kil (Department of Neurosurgery, College of Medicine, Hallym University)
  • 투고 : 2007.01.10
  • 심사 : 2007.03.21
  • 발행 : 2007.06.30
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초록

Marjolin's ulcer is a rare and often-aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We experienced two cases after burns. Case I involved a forty eight year-old man who had suffered from a flame burn at the parietal scalp area, where had been initially described three years earlier as a full-thickness wound including the pericranium. The man consulted us for a persistent ulcerative and infected wound on the burned lesion during the last 24 months, which turned out on the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) to be the squamous cell carcinoma with involving the skull and the dura mater. Although the posterior auricular lymph node was enlarged on the ipsilateral side, recent positron emission tomography (PET) CT did not show any metastatic lesion. It was impossible for us to resect the intracranial involvement of the tumor radically, and the postoperative PET CT still showed a focal fluorodeoxyglucose (FDG) uptake around the wall of the superior sagittal sinus. We think that an aggressive combined approach is essential for treatment in early stages for a high success rate, before the intracranial structures are involved because there is no consensus on the treatment for advanced disease, and the results are generally poor. Case 1 also did not involve a radical resection because of the intracranial invasion to the wall of superior sagittal sinus and the possibility of damage to the major cortical veins. He received adjuvant radiotherapy and must be followed periodically. Case 2 involved an eighty six year-old women who suffered from a painful scalp ulcer lesion after flame burns three years earlier. Unlike case 1, neither tumor infiltration into the dura nor lymph node enlargement was observed on the contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) CT. We did a radical resection of the tumor, including the involved bone, and a cranioplasty with bone cement.

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참고문헌

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