Is surgery an effective and adequate treatment in advanced Marjolin's ulcer?

Aydoğdu, Eser; Yıldırım, Serkan; Aköz, Tayfun

doi:10.1016/j.burns.2005.02.008

Cited by 77 publications

(96 citation statements)

References 18 publications

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“…The mechanisms of malignant change is supposed to be a sequence of repeated ulceration and healing in the ulcers and osteomyelitic sinuses and of repeated trauma in scars. Some proposed mechanisms include a carcinogenic toxin produced from the burned tissue, the cicatricial tissue which prevents the action of the immune system on the new tumour formation, and finally a two-step process involving an initiator and promoter leading to cancer 2,4,9,10 . We believe that trauma is the most important initiating factor in the pathogenesis of the Marjolin's ulcer as in our case.…”

Section: Discussionmentioning

confidence: 99%

“…Most burn scar carcinomas are of squamous cell type as in our case, however basal cell carcinoma, adenocarcinoma, malignant melanoma and mesenchymal malignancy have been documented [2][3][4]6,9,11 . All parts of the body can be affected by this malignancy, but extremities, trunk and scalp are the most frequently involved.…”

Section: Discussionmentioning

confidence: 99%

“…Invasion of the skull, dura mater and the brain is quite exceptional and has only been reported in a limited number of cases 1,2,7-9 . Two variants of Marjolin's ulcer have been described; an acute form, in which the cancer occurs within one year of the injury and a chronic form in which malignant changes are more than one year from the date of injury 2,7 . The average latency in chronic form is 36 years, and in our case was longer.…”

Section: Discussionmentioning

confidence: 99%

“…It tends to develop over atrophic, unstable burn scars many years after the burn injury has occurred [1][2][3][4][5] . Though it is known as a plastic surgical problem, when it invades the dura and brain it becomes of neurosurgical interest.…”

Section: Introductionmentioning

confidence: 99%

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Penetrating Marjolin's ulcer of scalp involving bone, dura mater and brain caused by blunt trauma to the burned area

Sengul

Hadi-Kadioglu

2009

Neurocirugía

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SummaryMarjolin's ulcer, which was first described more than 1.5 centuries ago, involves a rare malignant transformation of chronic scar tissue or ulcer. Marjolin's ulcer invading the skull, dura mater and the brain is quite exceptional. A case is presented of a patient with a massive Marjolin's ulcer arising in chronic scarring of the scalp following a fire burn 57 years previously. The tumour had invaded the skull, dura mater and the brain. The patient was treated surgically but died after 20 days. This report aims to highlight the importance of appropriate and expeditious initial wound management of scar ulcers of the scalp.KEY WORDS: Brain. Marjolin's ulcer. Scalp. Squamous cell carcinoma.Úlcera penetrante de Marjolin, que afecta al hueso, duramadre y cerebro, causada por un golpe romo en una cicatriz de quemadura. ResumenLa úlcera de Marjolin, que se describió por vez primera hace más de siglo y medio, se refiere a la rara transformación maligna de una vieja cicatriz o de una úlcera crónica. La úlcera de Marjolin, que invada el cráneo y el cerebro es bastante excepcional. Se presenta el caso de un paciente con una extensa úlcera de Marjolin, que aparece en una cicatriz secundaria a una quemadura ocurrida 50 años antes. El tumor había invadido el cráneo, la duramadre y el cerebro. Se enfermo murió 20 días después de la intervención quirúrgica. Este trabajo tiene como fin destacar la importancia de un tratamiento, rápido y apropiado, de las cicatrices ulceradas del cuero cabelludo.PALABRAS CLAVE: Cerebro. Ulcera de Marjolin. Cuero cabelludo. Carcinoma células escamosas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Penetrating Marjolin's ulcer of scalp involving bone, dura mater and brain caused by blunt trauma to the burned area

Sengul

Hadi-Kadioglu

2009

Neurocirugía

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“…In symptomatic patient and patients with suspicious examination finding imaging should be done. Imaging primarily consists of ultrasound of regional lymph nodes and X-ray chest [12]. After first 2 years patient should be followed every 6 months and after 5 years he should be followed yearly.…”

Section: Editorialmentioning

confidence: 99%

Marjolin’s Ulcer

Goel¹

2017

CDOAJ

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Image of the Month—Diagnosis

2006

Arch Surg

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Marjolin Ulcer C linical suspicion led to an incisional biopsy, the specimen of which demonstrated a verrucous squamous cell carcinoma. Inguinal lymph nodes were not palpable. The patient was taken to the operating room for wide local excision and skin grafting. Further histopathologic examination of the excised lesion revealed a moderately differentiated squamous cell carcinoma measuring 11ϫ6.5 cm with a depth of 15 mm and clear excisional margins. The patient made an uneventful recovery. The patient was closely followed up and at 15 months remained free of recurrence. Marjolin ulcer is a malignant change in a longstanding ulcer and/or scar tissue. Commonly, these lesions are treated as chronic ulcers or infections, leading to delayed diagnosis and resulting in the need for more extensive surgery and increased risk of metastasis. 1 Suspicion of malignant change should be raised with crusting, ulceration of scar tissue, increase in pain or size of the ulcer, and bleeding. 2 Marjolin ulcers have a 1% to 2% incidence in all burns but can also develop from previously traumatized and scarred tissue of other etiologies. 3 The malignant transformation has no predilection for race but is more predominant in the late 50s, with a typical lag time after injury of 20 to 40 years. 4 Malignant transformation presents as squamous cell carcinoma in 75% to 96% of the cases. Other neoplasms, such as basal cell carcinomas, melanoma, osteogenic sarcoma, fibrosarcoma, and liposarcoma, have been reported. 5,6 Grades of differentiation vary and are described as well differentiated (35%), moderately differentiated (55%), and poorly differentiated (10%). 7

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Is surgery an effective and adequate treatment in advanced Marjolin's ulcer?

Cited by 77 publications

References 18 publications

Penetrating Marjolin's ulcer of scalp involving bone, dura mater and brain caused by blunt trauma to the burned area

Penetrating Marjolin's ulcer of scalp involving bone, dura mater and brain caused by blunt trauma to the burned area

Marjolin’s Ulcer

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