SQUAMOUS CELL CARCINOMA ARISING IN CHRONIC LYMPHEDEMA OF THE RIGHT LOWER LIMB: A RARE CASE OF MARJOLIN’S ULCER IN A FILARIAL LIMB

Abstract

Background: Marjolin’s ulcer is a rare, aggressive malignancy developing in chronically inflamed or scarred tissues. While most often associated with burn scars, chronic lymphedema—particularly filarial—can also undergo malignant transformation.

Case Presentation: We present a 70-year-old male with a 30-year history of right lower limb filariasis who developed a chronic, non-healing ulcer over the dorsum of the foot. Histopathological examination confirmed well-differentiated squamous cell carcinoma. Considering the absence of lymph node involvement and the risks associated with below-knee amputation (BKA) in a filarial limb, the patient underwent forefoot amputation with fillet flap reconstruction.

Conclusion: This case emphasizes the feasibility of limb-preserving surgery in carefully selected patients with SCC arising in chronic lymphedema. The use of a fillet flap allowed optimal soft tissue coverage, avoided major amputation, and preserved ambulation.