The development of a Marjolin's cancer in a human immunodeficiency virus-positive hemophilic man and review of the literature.

BACKGROUND

The malignant potential of chronic ulcers and scars secondary to a variety of injuries is well characterized in the medical literature. Furthermore, it has been reported that human immunodeficiency virus (HIV)-positive patients have a higher incidence of basal cell carcinoma (BCC) than the general population.

OBJECTIVE

To describe a case of an unusually aggressive morpheaform BCC that developed in a 28-year-old HIV-positive patient. The tumor developed in a scar 25 years after the initial trauma (Marjolin's ulcer).

METHODS

Description of a case and review of the literature of Marjolins ulcer.

RESULTS

The tumor was removed in a seven-stage, 21-section, micrographically controlled excision. Intraoperatively, perineural invasion of the infraorbital nerve was observed. The postoperative defect was repaired using a full-thickness skin graft.

CONCLUSION

Although most malignancies arising within chronic scars are SCCs, BCCs and a number of other tumors have been described. Mohs micrographic surgery was effective in treating this aggressive morpheaform BCC. A high degree of suspicion in any changing healed scar is recommended.