| Sumario: | Aim: Chronic wounds are important health-care problem linked to multiple complications. Rarely, malignant transformation occurs. We present a case of 69-year-old male patient with malignant transformation occurring in a chronic leg ulcer due to venous insufficiency. Results / Discussion: Prior referral to Department of undersea and hyperbaric medicine, for adjunctive hyperbaric oxygen therapy, the patient has been treated for three years due to recurrent chronic wound on lateral malleolus of the right foot. The first occurrence of venous ulcers affecting both legs was 10 years previously. Ulcer size decreased during previous treatment but tissue infiltration, initially considered to be a hypergranulation tissue, affecting distal part of the ulcer slowly progressed during the last 6-month period. Initial examination revealed hypostatic changes and oedema on both legs with dermatosclerosis and cicatrices due to previous ulcers and ulcer affecting lateral malleolar region of the right leg, 6 cmx5 cm in diameter with sparse granulation and some fibronecrotic tissue feeling the ulcer bed and verrucose infiltration with increased border affecting distal part of the wound in 3 cmx4 cm in diameter. Biopsy and pathohistological analysis confirmed well differentiated squamous cell carcinoma. The patient has been treated with fractionated radiation therapy in cumulative dose of 5200cGy leading to tumor regression and some increase in ulcer size. Following radiation therapy, the patient was treated with hyperbaric oxygen treatment in order to speed up ulcer healing process. During the 6-month follow-up period there was no sign of tumor reoccurrence. Conclusion: The physicians treating chronic wound patients should be aware of malignant alteration as a possible complication occurring in chronic leg ulcer.
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