Intraoperative Cytological Evaluation of Marjolin Ulcers

Abstract

Background: Marjolin ulcers are malignant neoplasia developing in chronic open wounds and pathological scars. A definitive diagnosis is made by histological examination of permanent sections. Frozen section biopsy has been widely used for intraoperative diagnosis and evaluation of surgical excision safety margins. This preliminary study aims to discuss the reliability of a simpler and faster method - intraoperative cytology - in the diagnosis of Marjolin ulcers. Patients and Methods: Touch or scrape smears of 76 Marjolin ulcers from 22 patients were assessed, and features were compared to the histological appearance of permanent sections. Results: Cytology revealed squamous cell carcinoma (SCC) in 45 ulcers from 11 patients. Histology confirmed SCC in 48 ulcers from 12 patients. No false-positive and one falsenegative results were found. Cytology was found to have a 98.7% accuracy, 98% sensitivity and 100% specificity in the intraoperative diagnosis of Marjolin ulcers. Conclusions: Cytology is a fast and reliable alternative in the intraoperative diagnosis of Marjolin ulcers.

Patient-Related Delay in Presentation for Cutaneous Squamous Cell Carcinoma. A Cross-Sectional Clinical Study

“…Similarly, Renzi et al [4] did not find a significant impact of cancer history on early care seeking. The role of chronic lesions in delayed presentation has been previously addressed [2,3,4,9], as patients tend to think of changes in these lesions as benign transformations, while in reality, SCCs developing in chronic wounds and scars have a more aggressive biological behavior [15]. Patients with preexisting burn or unstable scars, chronic sinuses, and premalignant lesions should be thoroughly informed and educated about self-examination and identification of any changes as alerting signs rather than natural or degenerative harmless symptoms [3,4,13,15].…”