Soto-Dávalos BA, Cortés-Flores AO, Bandera-Delgado A, Luna-Ortiz K, Padilla-Rosciano AE

Language: Spanish
References: 14
Page: 329-331
PDF size: 54.65 Kb.

ABSTRACT

Background: Marjolin’s ulcer forms part of a group of neoplasms that originate in a burn scar, a phenomenon associated with superficial tissue trauma. Frequency of Marjolin’s ulcer is low and represents between 2 and 5% of all squamous cell carcinomas of the skin. This condition is found three times more frequently in men than in women and is thought to be more aggressive than conventional squamous cell carcinoma of the skin.
Clinical cases: We present two cases of squamous cell carcinoma that originated on a burn scar. 41 year old woman with gasoline burn on the left foot, 3 months old, in whom an exofitic ulcerated lesion on the right calcaneum region has evolved since she was 32 years old. Left transtibial amputation was decided. Another woman who started its suffering 9 years after a thorax burn with a progressive fungus lesion on the scar area. For its size and as it was a high degree neoplasia, surgical resection and radiotherapy to the zone of the primary with 50 Gy in 25 fractions was decided.
Conclusions: Marjolin’s ulcer usually occurs in old, ungrafted burn sites that were left to heal secondarily. Although it is believed that there is a latency period of 25-40 years after burn injury before the occurrence of malignancy, this may occur in a period as short as 3 months. Recurrence after radical surgery is 14.7%. Nonetheless, because of the aggressive behavior of this type of cancer, appropriate radical treatment allows an adequate control of the disease. Early grafting of the burn site can prevent the formation a malignant neoplasm. This condition should be suspected in a non-healing chronic ulcer on a burn scar.

REFERENCES

1. Aydogdu E, Yildirim S. Tafun A. Is surgery effective and adequate treatment in advanced Marjolin’s ulcer? Burns 2005;31:421-431.

2. Kowal-Vern A, Criswell BK. Burn scar neoplasms: a literature review and statistical analysis. Burns 2005;31:403-413.

3. Yucel A, Yazar S, Demirkesen C, Duran H, Dervisoglu S, Altintas M. An unusual long-term complication of burn injury: malignant fibrous histiocytoma developed in chronic burn scar. Burns 2000;26:305-310.

4. Uysal A, Kocer U, Sungur N, Cologlu H, Kankaya Y, Ulusoy MG, Tiftikcioglu YO, Yalta T. Marjolin’s ulcer on frostbite. Case report. Burns 2005;31:792-794.

5. Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M. The AJCC Cancer Staging Manual. 6th ed. New York: Springer Verlag;2002.

6. Thio D, Clarkson JHW, Misra A, Srivastava S. Malignant change after 18 months in a lower limb ulcer: acute Marjolin’s revisited. BJPS 2003;56:825-8.

7. North JH, Spellman JE, Driscoll D, Velez A, Kraybill WG, Petrelli NJ. Advanced cutaneous squamous sell carcinoma of the trunk and extremity: analysis of prognostic factors. J Surg Oncol 1997;64:212-217.

8. Treves N, Pack GJ. The development of cancer in burn scars: an analysis and report of 34 cases. Surg Gynecol Obstet 1930;51:749-782.

9. Novick M, Gard DA, Hardy SB, Spira M. Burn scar carcinoma: a review and analysis of 46 cases. J Trauma 1977;17:809-817.

10. Copcu E, Culhaci N. Marjolin’s ulcer on the nose. Burns 2002;28:701-704.

11. Gupta NP, Iqbal S, Nabi G, Ansari MS, Mandal S. Marjolin’s ulcer of the suprapubic cystostomy site infiltrating the urinary bladder: a rare occurrence. Urology 2000;56:330.

12. Gannon CJ, Rousseau DL Jr, Ross MI, Johnson MM, Lee JE, Mansfield PF, et al. Accuracy of lymphatic mapping and sentinel lymph node biopsy after previous wide local excision in patients with primary melanoma. Cancer 2006:107;2647-2652.

13. Renzi C, Caggiati A, Mannooranparampil TJ, Passarelli F, Tartaglione G, Pennasilico GM, et al. Sentinel lymph node biopsy for high risk cutaneous squamous cell carcinoma: case series and review of the literature. Eur J Surg Oncol 2007:33;364-369.

14. Ross AS, Schmults SD. Sentinel lymph node biopsy in cutaneous squamous cell carcinoma: a systematic review of the English literature. Dermatol Surg 2006:32;309-321.