Pressure sore carcinoma.

The development of squamous cell carcinoma in pressure sores is a rare event, considering the high incidence of pressure sores within the elderly and paraplegic populations. The clinical courses of 10 patients with pressure sore carcinoma have been reviewed. The presence of a velvety, cauliflower-like growth on the surface of a long-standing pressure sore should alert the surgeon to the possibility of malignant degeneration. Most of these tumors are well-differentiated squamous cell carcinomas. Of the 10 patients, 8 (80%) died from massive local recurrence or distant metastases an average of 17 months after resection and flap closure despite having apparently localized disease. One patient was disease free when lost to follow-up at 2 years, and 1 patient is without evidence of recurrence or metastases 3 months postoperatively. Altered immunocompetence may play a role in the rapid progression and high mortality associated with this tumor after surgical manipulation.