{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T13:07:45Z","timestamp":1769605665107,"version":"3.49.0"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,4,25]]},"abstract":"<jats:p>Cutaneous squamous cell carcinoma (cSCC) currently affects over 700\u2009000 patients per year in the USA alone, and its incidence continues to rise in recent years. A known risk factor for cSCC is chronic inflammation; a cSCC that develops at a site of chronic inflammation is known as Marjolin\u2019s ulcer. We present the case of a 76-year-old man with end-stage renal disease requiring chronic haemodialysis who developed an invasive cSCC at the cannulation site of an underlying arteriovenous (AV) fistula. In this instance, treatment with standard surgical excision or Mohs surgery would pose unique risks associated with injury to an otherwise functional AV fistula. Thus, the lesion was treated with electron beam radiation therapy, which offers a similar efficacy to surgery while minimising risk to the fistula. This resulted in a successful oncological outcome with no complications.<\/jats:p>","DOI":"10.1136\/bcr-2016-218932","type":"journal-article","created":{"date-parts":[[2017,5,6]],"date-time":"2017-05-06T09:05:14Z","timestamp":1494061514000},"page":"bcr-2016-218932","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Management of a cutaneous squamous cell carcinoma overlying an AV fistula"],"prefix":"10.1136","volume":"2017","author":[{"given":"Neel Som","family":"Nath","sequence":"first","affiliation":[{"name":"School of Medicine, Duke University, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian F","family":"Gilmore","sequence":"additional","affiliation":[{"name":"Surgery, Duke University Medical Center, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard K","family":"McCann","sequence":"additional","affiliation":[{"name":"Surgery, Vascular Surgery, Duke University Medical Center, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J","family":"Mosca","sequence":"additional","affiliation":[{"name":"Surgery, Advanced Oncologic and GI Surgery, Duke University Medical Center, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,5,6]]},"reference":[{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.11.037"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.2","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1056\/NEJM200103293441306","article-title":"Cutaneous Squamous-Cell Carcinoma","volume":"344","author":"Alam","year":"2001","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1011-1344(01)00198-1"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.4","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.275"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.5","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2002.125579"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.6","doi-asserted-by":"crossref","first-page":"121","DOI":"10.12968\/jowc.1998.7.3.121","article-title":"Marjolin\u2019s ulcer and chronic burn scarring","volume":"7","author":"Akguner","year":"1998","journal-title":"J Wound Care"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.7","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/153.6.559"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.8","doi-asserted-by":"crossref","first-page":"2142","DOI":"10.1038\/jid.2009.31","article-title":"The effect of having an affected Parent or Sibling on Invasive and in Situ Skin Cancer risk in Sweden","volume":"129","author":"Hussain","year":"2009","journal-title":"J Invest Dermatol"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(98)90198-8"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.10","first-page":"60","article-title":"A comprehensive review on Marjolin\u2019s Ulcers: Diagnosis and Treatment","volume":"3","author":"Pekarek","year":"2011","journal-title":"J Am Col Certif Wound Spec"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.11","doi-asserted-by":"crossref","first-page":"e43","DOI":"10.1016\/S0272-6386(04)00829-7","article-title":"Squamous cell carcinoma in situ arising at the exit site of a tunneled catheter","volume":"44","author":"Hammes","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.12","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.113476"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.13","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1111\/jdv.12031","article-title":"European guidelines for topical photodynamic therapy part 1: treatment delivery and current indications - actinic keratoses, Bowen\u2019s disease, basal cell carcinoma","volume":"27","author":"Morton","year":"2013","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f6153"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.15","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1111\/j.1365-2230.2011.04056.x","article-title":"Interventions for non-metastatic squamous cell carcinoma of the skin: a summarised Cochrane review","volume":"36","year":"2011","journal-title":"Clin Exp Dermatol"},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.16","unstructured":"Motley R , Preston P , Lawrence C . Multi-professional guidelines for the management of the patient with primary cutaneous squamous cell carcinoma 2009 [Internet]. London: British Association of Dermatologists, 2009. http:\/\/www.bad.org.uk\/healthcare-professionals\/clinical-standards\/clinical-guidelines\/scc (accessed May 2017)."},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.17","unstructured":"Scottish Intercollegiate Guidelines Network (SIGN). Management of a primary cutaneous squamous cell carcinoma [Internet]. Edinburgh: SIGN, 2014. http:\/\/www.sign.ac.uk\/pdf\/SIGN140.pdf (accessed May 2017)."},{"key":"2025082805362787000_2017.may06_1.bcr-2016-218932.18","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23143"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-218932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:36:36Z","timestamp":1756384596000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-218932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,6]]},"references-count":18,"alternative-id":["10.1136\/bcr-2016-218932"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-218932","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,6]]}}}