Marjolin Ulcer Developed in Osteomyelitis Fistula: A Rare Clinical Entity That Should Not Be Overlooked

The term Marjolin ulcer is used to refer to a malignant change accompanying chronic burn scars or chronic wounds. A 53-year-old male patient is presented with a nonhealing wound on his left leg that developed after a comminuted fracture in a traffic accident 33 years ago. The patient had a history of frequent antibiotic use and repeated operations due to osteomyelitis. Purulent discharge and granulation tissue were detected at the opening of the osteomyelitis fistula. Histopathologic examination of the wound debridement material revealed invasive squamous cell carcinoma in one area. In chronic wounds and osteomyelitis fistulas, if chronic ulceration does not heal for more than 3 months, the wound edges are rolled out, and, especially in the presence of raised or increased granulation tissue, it is vital to remember Marjolin ulcer and obtain a biopsy. This case is presented to remind every clinician dealing with chronic wounds that they should keep in mind the risk of cancerization over time in chronic wounds that do not heal.