Primary intracranial malignant tumour mistaken for a postburn scalp Marjolin's ulcer

Cavadas, Pedro C.; Baena-Montilla, P.; Jordá-Cuevas, M.; Vera-Sempere, Francisco

doi:10.1016/0305-4179(95)00147-6

Cited by 12 publications

(19 citation statements)

References 3 publications

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“…9 term scar is diagnostic of malignant epithelial transformation and should be considered as Marjolin's ulcer unless there is evidence to the contrary. 2 Morphologically, burn scar carcinoma may be of two types. Most commonly they are flat, ulcerative, infiltrative lesions with elevated margins and surrounding indurations (Fig.…”

Section: Pathogenesismentioning

confidence: 99%

Marjolin’s Ulcer: A Preventable Complication of Burns?

Copçu

2009

Plastic and Reconstructive Surgery

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Marjolin's ulcer is a rare and aggressive cutaneous malignancy that arises on previously traumatized and chronically inflamed skin, especially after burns. This clinical condition was first described by Marjolin in 1828. The term "Marjolin's ulcer" has been generally accepted to refer to a long-term malignant complication of the scars resulting from burns. However, vaccination, snake bites, osteomyelitis, pilonidal abscesses, pressure sores, and venous stasis may also induce this tumor. Clinically, reports suggest that atrophic and unstable scars tend to develop into cancer. Various etiological factors have been implicated in the condition, including toxins released from damaged tissues, immunologic factors, cocarcinogens, and miscellaneous factors such as irritation, poor lymphatic regeneration, antibodies, mutations, and local toxins. The incidence of burn scars undergoing malignant transformation has been reported to be 0.77 to 2 percent. All parts of the body can be affected, but the extremities and the scalp are most frequently affected. There are two variants: acute and chronic. In the former, the carcinoma occurs within 1 year of the injury. The chronic form is more frequent and malignancy tends to develop slowly, with an average time to malignant transformation of 35 years. Although many different cell types can be seen in these lesions, the major histological type is squamous cell carcinoma. Marjolin's ulcers are generally considered as very aggressive tumors with a higher rate of regional metastases; radical excision is the treatment of choice, but there is no consensus on lymph node dissection. Marjolin's ulcer can be insidious and often leads to a poor prognosis, and deaths from Marjolin's ulcer are not uncommon. Meticulous wound care is a crucial step in prevention of these lesions.

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Section: Pathogenesismentioning

confidence: 99%

Marjolin’s Ulcer: A Preventable Complication of Burns?

Copçu

2009

Plastic and Reconstructive Surgery

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“…Dark skinned individuals are not prone to solar skin cancers,[2] but a traumatic burn with healing by secondary intention is noted to be a significant factor in our case report. [257] Most burn scar carcinomas occur in patients who were not grafted or in areas of graft failure. [28] There is less frequent malignant transformation in burns that have been excised and grafted.…”

Section: Discussionmentioning

confidence: 99%

“…[47912] In the clinical presentation, noting a change in the sensation or appearance of the scar or ulcer mandates a histological assessment. As with most tumours, early treatment renders the best prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…As with most tumours, early treatment renders the best prognosis. [713] In our patient, the health system can be heavily criticized for failing to recognize the disease process in a patient who presented regularly for treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Frozen sections are useful when vital structures border the resection margins. [27] At times, irregular scar edges and surfaces need to be excised with larger margins using appropriate surgical judgment. [213] If at all possible, clear margins are the best attempt at cure.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Advanced Marjolin′s ulcer of the scalp in a 13-year-old boy treated by excision and free tissue transfer: Case report and review of literature

Daya¹,

Balakrishan²

2009

Indian J Plast Surg

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Marjolin's ulcer originates in chronic scars and wounds of diverse origin. This relatively rare tumour is most commonly a squamous cell carcinoma. The reason for malignant transformation is not well understood. The burn scar is a common predilection. We present the youngest patient in the literature, a 13-year-old male with a locally advanced squamous cell carcinoma of the scalp with intracranial extension following an unhealed burn injury at the age of three. Bilateral cervical lymphadenopathy was also noted. The tumour was excised and the large defect overlying the brain was covered by free latissimus dorsi musculocutaneous flap. At four weeks a therapeutic bilateral selective neck dissection was done. Adjuvant chemotherapy was administered. This report reiterates the importance of early diagnosis. Free tissue transfer further enhances our ability to cover complex defects associated with excision of advanced lesions.

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Deep intracranial extension of squamous cell carcinoma of the scalp

Etlik

Bay

İzmirli

et al. 2005

Pediatric Blood & Cancer

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We report a case of recurrent squamous cell carcinoma (SCC) of the scalp with deep cerebral invasion in a 15-year-old girl. Plain films and CT showed extensive, full thickness, and skull destruction at the vertex. Gadolinium-enhanced MRI revealed neoplastic invasion of the meninges and both cerebral hemispheres down to the lateral ventricle. This case represents an example of (SCC) imitating a primary brain tumor by exhibiting intracranial extension.

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Primary intracranial malignant tumour mistaken for a postburn scalp Marjolin's ulcer

Cited by 12 publications

References 3 publications

Marjolin’s Ulcer: A Preventable Complication of Burns?

Marjolin’s Ulcer: A Preventable Complication of Burns?

Advanced Marjolin′s ulcer of the scalp in a 13-year-old boy treated by excision and free tissue transfer: Case report and review of literature

Deep intracranial extension of squamous cell carcinoma of the scalp

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