PMC7317167_01
(a) Findings obtained when the patient visited our hospital.. The ulcer affecting the left chest wall extended from the subclavian to xiphoid levels. The third, fourth, fifth, and sixth costal cartilages and bones were missing, and parts of the lung and pericardium could be seen. (b) Computed tomography image.. The ulcer was deep enough to expose the pericardium. Computer tomography image.. There is only a small gap between the ulcer and the heart.
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The third, fourth, fifth and sixth costal cartilages and bones were missing, and parts of lung and pericardium could be seen (Fig. 1a, b). We debrided the ulcer with the help of a thoracic surgeon and reconstructed the chest wall with Marlex mesh and a pedicled rectus abdominus flap (Fig. 1).
Intraoperative image obtained just after debridement.
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Four months later mesh removal and 7 months before the last follow up, three fistulas which were lined by verrucous tissue, formed (Fig. 2).
Findings obtained one year and four months later.. After the first surgery, three fistulas, which were lined by verrucous tissue, formed.
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A histological examination of the verrucous tissue revealed well-differentiated SCC (Fig. 3).