Clinical Features and Expression Patterns for Burn Patients Developed Marjolin Ulcer

Marjolin Ulcers of the Scalp Post Trauma and of the Neck Post Radiation, Diagnosis, and Reconstruction

What are potential causes of Marjolin ulcer and how do they present?How are MU diagnosed?What are differential diagnoses for MU, and what can help differentiate them?What are the appropriate treatments for MU?

Giant exophytic Marjolin's ulcer of the lower leg after the gunshot wound: Case report

Introduction. Marjolin's ulcer is a skin malignancy that occurs on a scar or chronic wound. It most commonly occurs on a burn scar. Squamous cell carcinoma is the most common type of tumor, in more than 90% of cases. The rate of this rare malignant transformation is 1-2%. Marjolin's ulcer is more aggressive than other skin cancers. Wide excision is the treatment of choice. Recurrences are common. The aim of this article is to present a large exophytic carcinoma of the lower leg as a rare form of this tumor according to the size and type. The result of the radical surgery with reconstruction is also presented. Case report. Male patient, aged 52 years was presented by large exophitic tumor on the left lower leg. Tumor was located at the site of the previous gunshot injury. Latent period was 22 years. Tumor size was 14x12cm. Wide excision was performed (2-cm surgical margin) including the deep fascia and the defect was closed by split thickness skin graft from the opposite thigh. Histology showed well differentiated squamous cell carcinoma. There were no regional or distant metastases. One year after surgery there was no recurrence of the tumor. Conclusion. Early diagnosis of Marjolin's ulcer and wide excision are mandatory. Surgical margins for excision should be 2 cm and excision should include deep fascia. Multiple and repeated biopsies of the chronic wounds are advised. There is no consensus on staging of the Marjolin's ulcer and lymph node dissection.

Characteristics of Marjolin's Ulcers in 21st Century: A Retrospective Study, Systematic Review, and Surgical Guideline Recommendation

Marjolin's ulcer is rare and aggressive malignancy. The objective was to conduct a review of Marjolin's ulcer cases to gain a better understanding and its management. A retrospective study of patients with Marjolin's ulcers at our hospital between 2010 and 2019 was conducted. For the systematic review, the electronic database of the National Library of Medicine was searched and articles published between 2000 and 2019 were included. A total of 14 patients were included in the retrospective study. Twelve patients were male. The mean age was 59.71 years. The latency period was 27.78 years. The most common malignancy was squamous cell carcinoma, and 71.43% had developed on the lower extremities. Well-differentiated squamous cell carcinomas occurred in 38.46% of the cases Rates of lymphovascular and perineural invasion were 30.77 and 23.08%, respectively. Results from the literature search yielded 80 case reports (91 cases) and 42 retrospective reviews (1216 cases). Most cases were male and the most common location was lower extremities. The latency period for the acute and chronic periods was 2.75 months and 20.75 years, respectively. The most common malignancy was squamous cell carcinoma (92.27% in the retrospective reviews) and 59.98% of the cases exhibited well-differentiation. Rates of regional lymph node involvement and distant metastases were 10.20 and 12.09%, respectively. Marjolin's ulcer in 21st century is not so rare. The most common is well differentiated squamous cell carcinoma. Early flap surgery or skin grafts for chronic ulcers or burn scars are recommended to reduce risk. Guideline for surgical management is established.