Saltvig I, Matzen SH. Marjolin's ulcer in a 20 years old split thickness skin graft on the knee-A case report.
Int J Surg Case Rep 2017;
42:102-103. [PMID:
29241101 PMCID:
PMC5730427 DOI:
10.1016/j.ijscr.2017.11.059]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 11/25/2017] [Indexed: 11/29/2022] Open
Abstract
Marjolin’s Ulcer is a rare cutaneous neoplasm.
The condition should be suspected in a non- healing lesion in scar tissue.
Diagnosis is based on a combination of pathology and anamnesis.
Treatment varies from surgery to radiation -and chemotherapy.
Prognosis is dictated by size, lymph node status and metastasis at the time of diagnosis.
Objective
Marjolin’s Ulcer (MU) is a rare cutaneous neoplasm arising in cikatrical tissue. Due to its typical clinical presentation as a non-healing lesion in scar tissue, the diagnosis can be delayed and even overlooked.
Methods and results
We present the case of an elderly woman who developed an ulcerated, exophytic lesion in a split thickness skin graft (STSG) on the lateral aspect of the left knee. Histology showed a radically excised highly differentiated squamous cell carcinoma (SCC) with keratine pearls and a component of basocellular carcinoma (BCC). The histological picture combined with the location and long time interval since the primary surgery made the diagnosis of MU highly likely.
Discussion
Considering the risk of metastasis and mortality it is important to recognize the diagnosis and initiate adequate treatment.
Conclusion
The diagnosis of MU is clinical and confirmed by pathology. The typical long delay from the primary lesion to the malignant transformation might occlude the diagnosis. As such, a thorough anamnesis is essential in a non- healing ulcerated lesion in a cikatrical area to adequately diagnose and treat the condition.
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