{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:56:27Z","timestamp":1776387387307,"version":"3.51.2"},"reference-count":18,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,9,12]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>Spina bifida is a congenital malformation of foetal neural structures which may present as a skin fold or sac containing cerebrospinal fluid and neural structures with a variety of neurological deficits. Surgical repairs of spina bifida may not ensure complete functions, neural improvement or recovery. We present this palliative report of an adult male in his early 40s with a medical history of meningocele repair in his infancy, with long-standing Marjolin ulcers, fractures, contractures, diverting ileostomy and urostomy and a fungating mass externally measuring 33\u00d725 cm. The mass involved the buttocks, perineum and scrotum with a tumour overlying the meningocele and extending into the thigh through an internally draining tract. Factors such as immobility, pressure injuries and poor social support in the setting of chronic disability led to a conservative approach in the management of this unresectable carcinoma.<\/jats:p>","DOI":"10.1136\/bcr-2024-259682","type":"journal-article","created":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T01:45:22Z","timestamp":1727574322000},"page":"e259682","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Unresectable squamous cell carcinoma in a patient with spina bifida"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8625-2342","authenticated-orcid":false,"given":"Christopher Jude","family":"Pinto","sequence":"first","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA"},{"name":"Department of Medicine, Karnataka Institute of Medical Sciences Hubballi, Hubli, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"Muresan","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Muresan","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holli","family":"Neiman-Hart","sequence":"additional","affiliation":[{"name":"Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,9,28]]},"reference":[{"key":"2025082702084216000_17.9.e259682.1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.clsc.2016.11.001","article-title":"Unresectable cutaneous squamous cell carcinoma of the forehead with MLH1 mutation showing dramatic response to Programmed Cell Death Protein 1 Inhibitor Therapy","volume":"1","author":"Assam","year":"2016","journal-title":"Clin Skin Cancer"},{"key":"2025082702084216000_17.9.e259682.2","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1001\/jamadermatol.2015.2705","article-title":"A Case Report of Unresectable Cutaneous Squamous Cell Carcinoma Responsive to Pembrolizumab, a Programmed Cell Death Protein 1 Inhibitor","volume":"152","author":"Chang","year":"2016","journal-title":"JAMA Dermatol"},{"key":"2025082702084216000_17.9.e259682.3","doi-asserted-by":"crossref","DOI":"10.1186\/1743-8454-3-14","article-title":"Risk factors for pressure sores in adult patients with myelomeningocele--a questionnaire-based study","volume":"3","author":"Plaum","year":"2006","journal-title":"Cerebrospinal Fluid Res"},{"key":"2025082702084216000_17.9.e259682.4","first-page":"266","article-title":"Two case studies of Marjolin\u2019s ulcers in patients referred for management of chronic pressure ulcers","volume":"29","author":"Ratliff","year":"2002","journal-title":"J Wound Ostomy Continence Nurs"},{"key":"2025082702084216000_17.9.e259682.5","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/00006534-198601000-00017","article-title":"Carcinoma in chronic pressure sores: a fulminant disease process","volume":"77","author":"Mustoe","year":"1986","journal-title":"Plast Reconstr Surg"},{"key":"2025082702084216000_17.9.e259682.6","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2009-0210"},{"key":"2025082702084216000_17.9.e259682.7","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1159\/000485250","article-title":"Fungating Growth of Squamous Cell Carcinoma in Long-Standing Meningocele","volume":"53","author":"Goyal","year":"2018","journal-title":"Pediatr Neurosurg"},{"key":"2025082702084216000_17.9.e259682.8","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-312307"},{"key":"2025082702084216000_17.9.e259682.9","doi-asserted-by":"crossref","DOI":"10.1186\/1477-7819-8-108","article-title":"Marjolin\u2019s ulcers: theories, prognostic factors and their peculiarities in spina bifida patients","volume":"8","author":"Nthumba","year":"2010","journal-title":"World J Surg Oncol"},{"key":"2025082702084216000_17.9.e259682.10","doi-asserted-by":"crossref","first-page":"4633","DOI":"10.3892\/ol.2017.6068","article-title":"Palliative treatment of patients with inoperable locally advanced, recurrent or metastatic head and neck squamous cell cancer, using a low-dose and personalized chemotherapeutic regimen","volume":"13","author":"Bishnoi","year":"2017","journal-title":"Oncol Lett"},{"key":"2025082702084216000_17.9.e259682.11","doi-asserted-by":"crossref","first-page":"E53","DOI":"10.25270\/wnds\/2021.e5357","article-title":"Malignant Transformation in Chronic Stage IV Sacral Pressure Ulcer: A Case of Marjolin Ulcer","volume":"33","author":"Simman","year":"2021","journal-title":"Wounds"},{"key":"2025082702084216000_17.9.e259682.12","first-page":"108","article-title":"The Palliative Care of Patients With Incurable Cancer","volume":"116","author":"Simon","year":"2020","journal-title":"Dtsch Arztebl Int"},{"key":"2025082702084216000_17.9.e259682.13","unstructured":"Brea CM , Munakomi S . Spina Bifida. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK559265\/"},{"key":"2025082702084216000_17.9.e259682.14","doi-asserted-by":"publisher","DOI":"10.1177\/1049909113479153"},{"key":"2025082702084216000_17.9.e259682.15","doi-asserted-by":"crossref","DOI":"10.5826\/dpc.11S2a168S","article-title":"Radiotherapy in the Adjuvant and Advanced Setting of CSCC","volume":"11","author":"Muto","year":"2021","journal-title":"Dermatol Pract Concept"},{"key":"2025082702084216000_17.9.e259682.16","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1159\/000531925","article-title":"A Case of Tumor Lysis Syndrome during Palliative Radiotherapy for Breast Cancer Metastases","volume":"16","author":"Furusawa","year":"2023","journal-title":"Case Rep Oncol"},{"key":"2025082702084216000_17.9.e259682.17","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1093\/ptj\/83.3.263","article-title":"Musculoskeletal deterioration and hemicorporectomy after spinal cord injury","volume":"83","author":"Shields","year":"2003","journal-title":"Phys Ther"},{"key":"2025082702084216000_17.9.e259682.18","first-page":"1269","article-title":"How is the Long-Term Quality of Life Following Hemicorporectomy? A Case Report of a Patient with 16 Years of Follow-Up","volume":"3","author":"Gallucci","year":"2020","journal-title":"World J Surg Surg Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-259682","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:08:52Z","timestamp":1756285732000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-259682"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":18,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9,28]]},"published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1136\/bcr-2024-259682"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-259682","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}