Marjolin’s ulcer: a preventable malignancy arising from scars

Abstract

BackgroundMarjolin’s ulcer (MU) is a rare malignancy arising from various forms of scars. This potentially fatal complication typically occurs after a certain latency period. This article attempts to reveal the importance of the latency period in the prevention and early treatment of the malignancy.MethodsA retrospective review of 17 MU patients who underwent surgical procedures between June of 2005 and December 2011 was conducted. Etiology of injuries, latency period, repeated ulceration, and outcomes were recorded. This observational report reveals characteristics of patients who develop MU.ResultsAn incidence of 0.7% of MU was found amongst patients complaining of existing scars in our study; burns and trauma were the most common etiology of MU. The mean latency period was 29 years (SD = 19) and the mean post-ulceration period was 7 years (SD = 9). Statistical analysis revealed a negative correlation between the age of patients at injury and the length of latency period (r = −0.8, P <0.01), as well as the lengths of pre-ulceration and post-ulceration periods (r = −0.7, P <0.01).ConclusionsPatients experience different lengths of pre- and post-ulceration periods during the latency period. Younger patients tend to have a longer latency period. Skin breakdown on chronic scars and chronic unhealed ulcers are two main sources of MU. MU may be preventable with a close surveillance of the ulcer during the latency period.

Epidemiology and predictors of recurrence of Marjolin’s ulcer: experience from Mansoura Universityxs

“…1 The definition of MU is controversial because some authors include other types of malignancy (eg basal cell carcinoma, sarcoma) within this term, whereas other scholars include all carcinomas of scar tissue even if they have not been induced by a burn (eg venous ulcer, traumatic ulcer). 2 MU is more aggressive than malignancies occurring in normal skin. Nodal and distant spread seems to be less common initially due to extensive fibrosis occluding surrounding vessels.…”

Marjolin's ulcer: a rare entity with a call for early diagnosis

“…Non-MU SCCs had a metastatic rate of 3–10% compared against MU-SCCs, which had a higher metastatic rate of 27.5–40%, indicating a need for early treatment given their more aggressive nature 9. The current gold standard for MU diagnosis remains for the lesion to be biopsied 7. Histological grading is the most important factor indicating prognosis, with evidence of lymph node metastases returning the poorest prognosis 9 21…”

“…The most common histological findings in MUs are well-differentiated squamous cell carcinomas (SCC), which occur predominantly in burn wounds,7 although basal cell carcinomas (BCC) and malignant melanomas (MM) have been reported 8. Other malignancies are less likely as deeper tissues are usually undamaged and proliferate at a slower rate than the epidermis 9.…”

The Impact of Surgical Complications on Cancer Recurrence Rates: A Literature Review

“…Therefore, the repair process that is involved in post-operative wound healing may also contribute to tumour growth [41]. Where there is ongoing wound healing over a long period of time, cancer may even develop de novo in such conditions [42].…”