Marjolin’s Ulcers in sub‐Saharan Africa

Nthumba, Peter

doi:10.1007/s00268-010-0727-6

Cited by 23 publications

(24 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Current studies in Africa have reported that the mean age of patients with Marjolin's ulcers is lowering and appears to be affecting younger patients over the years [12,20]. It also appears that the transition time is getting shorter [20].…”

Section: Discussionmentioning

confidence: 99%

“…Studies from western countries have shown that the average age at diagnosis is in the fifth decade of life with a range of 18-84 years, and men are three times more frequently affected than women [11]. In Sub-Saharan Africa, Marjolin's ulcer appears to be affecting younger patients and the transition time is getting shorter over the years [12]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Marjolin's ulcers at a university teaching hospital in Northwestern Tanzania: a retrospective review of 56 cases

et al. 2012

View full text Add to dashboard Cite

BackgroundMarjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Although many individual case reports exist, no comprehensive evaluation of Marjolin's ulcer patients has been conducted in our setting. This study was conducted to describe the clinicopathological presentation and treatment outcome of this condition in our local setting and to identify predictors of outcome.MethodsThis was a retrospective study of histologically confirmed cases of Marjolin's ulcer seen at Bugando Medical Centre over a period of 10-years between January 2001 and December 2010. Data were retrieved from patients' files and analyzed using SPSS computer software version 15.0ResultsA total of 56 patients were studied. Male to female ratio was 2.1:1. Burn scars (89.3%) were the most common causative lesions of Marjolin's ulcer. The mean latent period between original injury and diagnosis of Marjolin's ulcer was 11.34 ± 6.14 years. Only 12.0% of the reported cases were grafted at the time of injury (P < 0.00). Most patients (48.2%) presented between one and five years of onset of illness. The lower limb (42.9%) was the most frequent site for Marjolin's ulcers. The median tumor size at presentation was 8 cm and the vast majority of patients (85.7%) presented with large tumors of ≥ 5 cm in diameter. Lymph node metastasis at the time of diagnosis was recorded in 32.1% of cases and distant metastasis accounted for 26.9% of cases. Squamous cell carcinoma (91.1%) was the most common histopathological type. Wide local excision was the most common surgical procedure performed in 80.8% of cases. Post-operative complication rate was 32.1% of which surgical site infection was the most common complication in 38.9% of patients. Local recurrence was noted in 33.3% of cases who were treated surgically. The mean length of hospital stay for in-patients was 7.9 ± 2.3 days. Mortality rate was 7.1%. According to multivariate logistic regression analysis, stage and grade of the tumor and presence of local recurrence were the main predictors of death (P < 0.001).ConclusionMarjolin's ulcers are not rare in our environment and commonly occur in burn scars that were not skin grafted and were left to heal secondarily. A high index of suspicion is required in the management of chronic non-healing ulcers and all suspected lesions should be biopsed. Early recognition and aggressive treatment of Marjolin's ulcers and close follow-up are urgently needed to improve outcomes in our environment.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Marjolin's ulcers at a university teaching hospital in Northwestern Tanzania: a retrospective review of 56 cases

et al. 2012

View full text Add to dashboard Cite

show abstract

“…supposed to be inversely proportional to the age of onset of predisposing condition. 9 Shortest lag period ranged from 4 weeks 10 to 70 years, 6 mean time being 36 years after sustaining burns.…”

Section: Discussionmentioning

confidence: 99%

“…5 Majority of cases reported are squamous cell carcinoma, 6 over the extremities, 7 commonest region of body involved are lower limbs 40%, 30% for head & neck regions, 20% for extremities & 10% for trunk. 7 Though various unifactorial theories like Virchow's theory of chronic irritation, 12 Friedwald and Rouse cocarcinogenic theory, 13 Treves and Pack's 1 toxin theory, Ribet's theory of epithelial implantation 9 etc. have been proposed for the pathogenesis of development of malignancy in scar patients, multifactorial theory have been propounded for malignant transformation, which proposes the combination of above theories as pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Marjolin's ulcer - dual lymph node metastasis with cystic degeneration: a rare presentation

et al. 2014

View full text Add to dashboard Cite

“…Also, although the duration of the Danish study was 25 years, 13 it is possible that this period was insufficient to cover the full latent period between exposure (time of burn injury) and disease (skin cancer development) in patients with burn scars, because clinical studies have reported mean latent periods ranging from 23 to 48 years. [16][17][18][19] The two population-based studies identified in this systematic review were well-defined cohorts accrued through national hospital inpatient registration. Because cancer registration is mandatory and almost 100% for all cancers in Denmark and Sweden, including keratinocytic skin cancers, it is likely that case ascertainment was close to complete, particularly for skin cancers occurring at the site of a previous burn injury.…”

Section: Discussionmentioning

confidence: 99%