Marjolin's ulcer associated with chronic osteomyelitis

Pandey, Mahendra Raj; Kumar, Prince; Khanna, Anil

doi:10.12968/jowc.2009.18.12.45607

Cited by 11 publications

(8 citation statements)

References 7 publications

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“…Recently, Marjolin ulcer definition is used synonymous with squamous cell carcinomas (SCC) detected on scar tissues. Although most frequent wound or scar type causing Marjolin ulcers is burns, cancer development on discoid lupus erythematosus lesions, osteomyelytic scars, amputation stumps, regions of chronic fistulas, regions of insect bites, vaccination sites, frostbites and other chronic wounds was previously defined in literature [6,7]. Burn scar carcinomas are frequently detected on extremities but approximately 20–30% develops on head and neck region [8].…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological evaluation of Marjolin ulcers over two decades

Oruç

Kankaya

Sungur

et al. 2017

The Kaohsiung J of Med Scie

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Malignant changes arising on the previously traumatized or chronically inflamed skin are defined as Marjolin ulcers. They can develop on many different lesions but frequently they are detected on burn scars. Histopathologically, Marjolin ulcers are mostly diagnosed as squamous cell carcinoma and they need special attention when especially located on the lower extremities. In this study, 63 patients treated for Marjolin ulcers between January 2000 and March 2015 were evaluated according to etiology, histological differentiation, primary tumor size, patient age and anatomical localization. Medical records of these patients were reviewed retrospectively. Mean age was 49.7 years. Average interval between the first injury and carcinoma development was 37.9 years. Most frequent etiologic factor was burn scars with 82.5%. Foot was the most frequently affected site with 28.6% and scalp was the second most frequent localization with 25.4%. Squamous cell carcinomas were detected in 88.9% of the patients and basal cell carcinomas were detected in 11.1% of the patients. For treatment, excision and grafting was performed for 48 patients (76.2%), excision and local flaps were used for 10 patients (15.9%) and excision and free flaps were used for five patients (7.9%). Regional lymph node dissection was performed for 12 patients (19%). Average follow up period was 46.5 months. Local recurrences were detected in nine patients (14.3%). In conclusion, Marjolin ulcers are aggressive tumors that require special care. In order to prevent life threatening sequelas of this entity, it is important to know basic aspects of clinical progress, prognostic factors and treatment modalities.

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Section: Introductionmentioning

confidence: 99%

Clinicopathological evaluation of Marjolin ulcers over two decades

Oruç

Kankaya

Sungur

et al. 2017

The Kaohsiung J of Med Scie

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“…A vast array of etiologies fall under the category ''chronic inflammation,'' including burn scars, stasis ulcers, fistula tracts, vaccination sites, osteomyelitis scars, pressure sores, snake bites, lupus erythematosus, and even frostbite. [1][2][3][4][5] The pathogenesis of Marjolin ulcer includes a prolonged healing phase, poor lymphatic regeneration in scars, misplaced epithelial cell groups, and the release of several toxins. 6 The malignant transformation of the ulcer is related to the duration of the ulcer.…”

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confidence: 99%

Marjolin Ulcer: Clinical Experience with 34 Patients over 15 Years

et al. 2013

J Cutan Med Surg

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Background: Malignancies that arise from scars are referred to as Marjolin ulcers. The association between chronic ulcers and squamous cell carcinomas is well established. There are many case reports in the literature regarding Marjolin ulcer; however, randomized controlled clinical series that describe a thorough evaluation of these patients are rarely encountered.Objective: We present our clinic's 15 years of experience with 34 Marjolin ulcer patients and their treatment modalities.Methods: A retrospective analysis of 302 squamous cell carcinoma patients who were treated in the plastic surgery department between 1997 and 2011 was performed. Thirty-four (10.3%) histopathologically confirmed Marjolin ulcer patients were further analyzed.Results: Although burn scars represented 77% of the patients in the present study, unstable scars that formed following traffic accidents and fistula tracts are also among the commonly encountered etiologies. Based on our observations, squamous cell carcinoma, in addition to malignant melanoma and verrucous carcinoma, is frequently observed in cases of Marjolin ulcers. Conclusion:If the goal is to eradicate this clinical entity, all of the chronic ulcers that fail to heal require biopsies at regular intervals. Large excisional margins, lymphadenectomies in cases of palpable lymph nodes, and a well-defined oncology protocol are all essential in treating Marjolin ulcer. Contexte: Les tumeurs malignes qui se dé veloppent aux dé pens des cicatrices sont appelées ulcè res de Marjolin. L'association entre les ulcè res chroniques et les carcinomes squameux est bien connue. La documentation contient de nombreux exposé s de cas d'ulcère de Marjolin, mais très peu de sé ries de cas cliniques, comparatives et alé atoires, faisant état d'une é valuation complè te des patients touchés. Objectif: Il sera question de notre expé rience accumulé e pendant 15 ans, dans notre é tablissement, chez 34 patients atteints d'un ulcè re de Marjolin ainsi que des diffé rentes formes de traitement. Mé thode: Il s'agit d'une analyse ré trospective de 302 cas de carcinome squameux, traité s au service de chirurgie plastique, de 1997 à 2011; 34 (10.3%) d'entre eux ont fait l'objet d'une analyse approfondie, l'examen histopathologique ayant ré vé lé la pré sence d'un ulcè re de Marjolin.Ré sultats: Les cicatrices de brû lure constituaient 77% des cas retenus dans l'é tude, mais les cicatrices instables, qui se forment à la suite d'accidents de la route, et les trajets fistuleux figurent aussi parmi les causes courantes de cette affection. D'aprè s les notes recueillies, le carcinome squameux, outre le mé lanome malin et le carcinome verruqueux, s'observe souvent dans les cas d'ulcère de Marjolin.Conclusions: Si le but est d'é liminer cette entité morbide, les biopsies à intervalles ré guliers s'imposent dans tous les cas d'ulcè re chronique qui ne cicatrise pas normalement. La ré alisation de bonnes marges saines, les lymphadé nectomies dans les cas de noeuds lymphoïdes palpables et l'é tablissement d'un protoco...

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“…Marjolin's ulcer seems to affect mostly disadvantaged patients with limited access to health care and neglected wounds, which often delays presentation, especially in developing countries 5 . Wide excision is recommended with large safety margins (2 to 3 cm) and closures of chronic skin wounds, and when this is not feasible, close evaluation.…”

Section: Discussionmentioning

confidence: 99%