Squamous cell carcinoma arising from chronic enteroatmospheric fistula

Marjolin ulcers are aggressive, cutaneous malignancies typically arising from chronic, nonhealing wounds. The presence of an obvious defect often masks this potentially life-threatening condition, making detection difficult and frequently leading to delayed diagnosis. Most cases of Marjolin ulcers are squamous cell carcinoma (SCC) in histology. Unlike for other common cutaneous malignancies, no clear guidelines or protocols are in place for early surveillance and management of Marjolin ulcers. Given the aggressive nature of this malignancy when associated with metastasis, early diagnosis and intervention are imperative. We present a unique case describing an immunocompromised patient with an extensive surgical abdominal history who had developed a cutaneous mass determined to be well-differentiated invasive SCC on final histology. The mass was superimposed over a chronic enteroatmospheric fistula that was present for more than 20 years.