J Korean Foot Ankle Soc.  2018 Jun;22(2):78-81. 10.14193/jkfas.2018.22.2.78.

Early Transformed Diabetic Foot Ulcer into a Malignancy: A Case Report

  • 1Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea. parkyounguk@gmail.com
  • 2Department of Orthopedic Surgery, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
  • 3Department of Plastic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.


This paper presents a case of an early malignant transformation of untreated ulcers in a patient with diabetes. This case shows that Marjolin's ulcer can occur not only after chronic injury, but can also develop in the early stages after the onset. Hence, an early biopsy for diabetic foot ulcers that fail to heal with acute treatment can enable an earlier diagnosis and treatment without amputation, resulting in a better quality of life for the patient.


Diabetic foot; Malignancy; Neoplasms

MeSH Terms

Diabetic Foot*
Quality of Life


  • Figure 1 Initial ankle lateral radiograph showing calcaneal destruction with Achilles tendon gas formation.

  • Figure 2 Magnetic resonance imaging showing bone marrow edema and enhancements at the calcaneus, cuboid bone, and navicular bone, and partial tear and severe tendinitis at the Achilles tendon.

  • Figure 3 Photograph showing unhealed ulceration on the heel.

  • Figure 4 Photograph showing an unhealed ulcer on patient's readmission two years later.

  • Figure 5 Pathological findings. Low-power field of H&E stained tissue revealed that the ulcer area showing invasive squamous cell carcinoma, well differentiated.

  • Figure 6 Evaluation of the metastasis. (A) Magnetic resonance imaging showing an ill-defined enhancing lesion sized 3.6×1.3×5.7 cm, the sole of the foot, and infiltration of the calcaneal tuberosity (arrow). Positron emission tomography/computed tomography scan showing inguinal (B) and popliteal (C) lymph node metastasis.


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