International Surgery Journal | May 2022 | Vol 9 | Issue 5 Page 1074 International Surgery Journal Metke R et al. Int Surg J. 2022 May;9(5):1074-1078 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Case Report Squamous cell carcinoma arising from suprapubic cystostomy: report of two cases and a narrative review of literature Ricardo Metke*, Andrea Araujo, Julián Chavarriaga, Catalina Villaquirán, Juan Guillermo Cataño, Maddy Mejía, Sergio Cervera Bonilla, Laura Castillo INTRODUCTION Squamous cell carcinoma (SCC) of the bladder is rare in the general population, accounting for less than 5% of all bladder tumors. Nevertheless, it is more frequent in the context of chronic inflammation and infection, as is the case of patients with chronic indwelling urinary catheters, bladder stones, diverticula or schistosomiasis, especially in endemic regions. 1 The first case of SCC of the suprapubic cystostomy tract (SCT) was published in 1993 by Stroumbakis et al. 2 The patient was an eighty-year-old male who required suprapubic cystostomy due to urethral stricture, and 5 years later he presented with SCC at the cystostomy site with involvement of the entire abdominal wall, but without bladder involvement. Subsequently, and to date, only 14 cases of this condition have been reported around the world. CASE REPORT A 71-year-old male with a history of spinal cord injury (SCI) due to a traffic accident in 1969, living with a suprapubic catheter since 1970 (50 years). In 2012, he presented with an exophytic mass at the cystostomy site. A biopsy reported a keratinizing, well-differentiated, infiltrating SCC, without vascular or perineural invasion. One of the ink-marked section edges was in contact with the carcinoma. Bladder involvement was ruled out by cystoscopy and cross-sectional imaging. Plastic surgery was performed for wide tumor resection and reconstruction of the abdominal wall, leaving 1 cm margins. The final pathology report was negative for malignancy. Eight years later, he presented with a new 4x3 cm erythematous, exophytic mass at the same location. A new punch biopsy revealed a keratinizing, ABSTRACT Squamous cell carcinoma arising from Marjolin’s ulcer of the suprapubic cystostomy tract is a rare entity that usually occurs in patients with a history of spinal cord injuries and a chronic indwelling catheter. We present 2 cases of this rare entity with the clinical exams needed for diagnosis and treatment according to individual characteristics of each case. Marjolin’s ulcer is a cutaneous malignancy that arises from injured skin. The most frequent type of malignancy identified on histopathologic examination is squamous cell carcinoma (80-90%). It can develop from long-standing scars, chronic wounds, pressure ulcers, osteomyelitis, and burns. Only cases have been reported about Marjolin’s ulcer with squamous cell carcinoma at the cystostomy cite. Treatment regimens have not been standardized; cases have received individualized treatments, usually with excision, radiation, or a combination of both. There is insufficient evidence to aid in the understanding of the etiology. In addition, there is no consensus on its optimal treatment and follow-up schemes. Keywords: Squamous cell carcinoma, Cystostomy, Urinary bladder neoplasms, Spinal cord injuries Department of Medicine, Pontificia Universidad Javeriana, Bogota, Cundinamarca, Colombia Received: 11 October 2021 Revised: 07 December 2021 Accepted: 17 January 2022 *Correspondence: Dr. Ricardo Metke, E-mail: rmetke@javeriana.edu.co Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2349-2902.isj20221158