Post‐burn scar malignancy: 5‐year management review and experience

Mousa, Ahmed; Elshenawy, Anwar; Maklad, Salah; Bebars, Shaimaa M.M.; Burezq, Hisham; Sayed, Sohair K.

doi:10.1111/iwj.13690

Cited by 7 publications

(2 citation statements)

References 51 publications

(176 reference statements)

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“…Reconstructive flap skin has been reported to develop severe epithelial dysplasia with concomitant deregulation of proliferation and increased p53 expression 28 . Additionally, carcinogenesis caused by chronic irritation is a well-known etiology, and a similar concept includes burn scar carcinogenesis 29 – 31 . Previously, “mucosalization,” the loss of skin appendages including sebaceous glands in the transplanted skin paddles, has been noted in the literature and is considered an inflammatory change caused by chronic irritation 32 , 33 .…”

Section: Discussionmentioning

confidence: 99%

Clinical and pathological features of second primary neoplasms arising in head and neck reconstructive skin flaps

Eguchi,

Kobayashi,

Honma

et al. 2023

Sci Rep

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The incidence of second primary neoplasms arising in the skin reconstructive flap (SNAF) is increasing because of the increase in head and neck flap reconstruction and cancer survival. Prognosis, optimal treatment, and their clinicopathological-genetic features are under debate and are difficult to diagnose. We retrospectively reviewed SNAFs based on a single center’s experience over 20 years. Medical records and specimens of 21 patients with SNAF who underwent biopsies between April 2000 and April 2020 at our institute were retrospectively analyzed. Definite squamous cell carcinoma and the remaining neoplastic lesions were subclassified as flap cancer (FC) and precancerous lesions (PLs), respectively. Immunohistochemical studies focused on p53 and p16. TP53 sequencing was conducted using next-generation sequencing. Seven and 14 patients had definite FC and PL, respectively. The mean number of biopsies/latency intervals was 2.0 times/114 months and 2.5 times/108 months for FC and PL, respectively. All lesions were grossly exophytic and accompanied by inflamed stroma. In FC and PL, the incidences of altered p53 types were 43% and 29%, respectively, and those of positive p16 stains were 57% and 64%, respectively. Mutation of TP53 in FC and PL were 17% and 29%, respectively. All except one patient with FC under long-term immunosuppressive therapy survived in this study. SNAFs are grossly exophytic tumors with an inflammatory background and show a relatively low altered p53 and TP53 rate and a high p16 positivity rate. They are slow-growing neoplasms with good prognoses. Diagnosis is often difficult; therefore, repeated or excisional biopsy of the lesion may be desirable.

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Section: Discussionmentioning

confidence: 99%

Clinical and pathological features of second primary neoplasms arising in head and neck reconstructive skin flaps

Eguchi,

Kobayashi,

Honma

et al. 2023

Sci Rep

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“…It is likely a multifactorial process with a genetic and environmental component playing a role in its development. The age of onset of scar is found to be inversely proportional to the latency period between scar and cancer [ 5 ]. Occurrence of Marjolin's ulcer is most commonly seen in the lower extremities (55%-70%), followed by the head and neck (20-25%), upper extremities (10-12%), trunk, and other rarer locations, including toe, eyelid, and lips [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Primary Tumor Variables on Predicting Nodal Metastasis in Lower Extremity Marjolin’s Ulcer: A Retrospective Cohort Study

Gupta,

Suryavanshi,

Singh

et al. 2023

Cureus

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BackgroundMarjolin's ulcer or scar carcinoma is a rare disease arising from the conversion of chronic scar into malignancy. Studies show Marjolin's ulcer squamous cell carcinoma has more chances of lymph nodal metastasis and is more aggressive with a worse survival rate. To date, no established guidelines exist for managing regional lymph nodes in cases of Marjolin's ulcer with clinically N0 nodes. Observation vs elective node dissection remains an option. In developing countries, long-term follow-up is not consistently leading to the risk of patients being kept on observation for regional nodes; presenting late with inoperable regional nodes is possible.This study aims to identify clinicopathological factors of lower extremity Marjolin's ulcer, which are associated with a high risk of inguinal lymph node metastasis. Identifying such risk factors may help provide a rationale for performing elective nodal dissection instead of observation in high-risk cases. Material and methodsAll clinically N0 lower extremity Marjolin's ulcer cases, more than 3 cm in size, treated at King George's Medical University, India, during the last five years, have been included in this study. Demographic, clinical, and pathological data of eligible patients were retrieved from institutional records. Various clinical and pathological factors were studied and correlated with lymph node positivity, and the strength of the correlation was tested using statistical methods. Factors correlated strongly with inguinal lymph node positivity were identified as high-risk factors.

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