Arif YILMAZ, Özgün ENGİN
Turkish Journal of Plastic Surgery - 2026;34(2):75-78
Chronic wounds are characterized by prolonged inflammation and impaired healing, often attributed to infection, vascular insufficiency, metabolic disease or mechanical trauma. When lesions remain refractory to treatment, malignancy must be included in the differential diagnosis. However, such wounds may also represent the first clinical manifestation of an underlying malignancy. We report two male patients (ages 51, 62) with chronic, treatment-resistant wounds persisting for months to years eventually diagnosed as malignancies: High-grade diffuse large B-cell lymphoma in a persistent axillary ulcer, and extranodal lymphoma in a lower-leg ulcer. Delayed diagnosis resulted from prolonged conservative care and nonspecific initial samples, and led to systemic symptoms. Early tissue biopsy, imaging, and multidisciplinary evaluation are critical to prevent diagnostic delays and improve prognosis. This case series aims to emphasize the clinical importance of malignancies that may initially present as chronic, nonhealing wounds.
