Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Medicine
Volume 2014 (2014), Article ID 715809, 3 pages
http://dx.doi.org/10.1155/2014/715809
Case Report

Squamous Cell Carcinoma (Marjolin’s Ulcer) Arising in a Sacral Decubitus Ulcer Resulting in Humoral Hypercalcemia of Malignancy

1Department of Dermatology, Dermatology Consultation Service, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
2City Medical Examiner, New York City Office of Chief Medical Examiner, New York, NY 10016, USA
3Section of Dermatopathology, Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA

Received 23 June 2014; Accepted 5 August 2014; Published 13 August 2014

Academic Editor: Jahn M. Nesland

Copyright © 2014 John T. O’Malley et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Long-standing burns, fissures, and ulcers that undergo malignant transformation into a variety of malignancies, including squamous cell carcinoma, is commonly referred to as a Marjolin’s ulcer. It is well recognized that squamous cell carcinomas of the lung and esophagus can cause humoral hypercalcemia of malignancy secondary to paraneoplastic secretion of parathyroid hormone-related peptide. However, it is extremely rare for a squamous cell carcinoma developing in a sacral decubitus ulcer to cause humoral hypercalcemia of malignancy. We describe the first case of a patient found to have elevated serum levels of parathyroid hormone related peptide related to his Marjolin’s ulcer. A 45-year-old African American man with T6 paraplegia and a sacral decubitus ulcer present for 20 years was admitted for hypercalcemia of unclear etiology. He was subsequently found to have elevated parathyroid hormone related peptide and an excisional biopsy from the ulcer showed invasive squamous cell carcinoma suggestive of humoral hypercalcemia of malignancy. The patient ultimately succumbed to sepsis while receiving chemotherapy for his metastatic squamous cell carcinoma. Humoral hypercalcemia of malignancy is a rare and likely underrecognized complication that can occur in a Marjolin’s ulcer.