[Diagnostic pitfall: basal cell carcinoma arising in a therapy-resistant chronic venous ulcer of the lower leg].

HISTORY: A 96-year-old woman attended our department with an ulcer on the lower leg. It looked typical of an ulcer due to chronic venous insufficiency an had been resistant to treatment for 20 years.

INVESTIGATIONS: On the left lower leg there was a 5 x 5 cm ulcer with a sharply demarkated border. Because of its chronicity and its resistance to treatment several biopsies were taken from its borders.

DIAGNOSIS, TREATMENT AND CLINICAL COURSE: Histopathologically examination revealed a basal cell carcinoma. The ulcer was excised with a wide margin and the wound closed with a mesh-graft.

CONCLUSION

This case demonstrates the need of re-evaluating the pathology of chronic ulcers due to venous stasis in the leg to exclude malignancy.