© Borgis - New Medicine 4/2014, s. 139-141
Marjolin’s ulcer of the thigh after burn injury – case report and review of literature
1Department of Oncology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
Head of Department: prof. Sergiusz Nawrocki, MD, PhD
2Department of Surgical Oncology, Hospital Ministry of Internal Affairs with Warmia and Mazury Oncology Centre, Olsztyn, Poland
Head of Department: Andrzej Lachowski, MD
Marjolin’s ulcer is defined as a tumor which is arising from a chronic wound, scar or chronic inflammation. It is a rare chronic cutaneous ulcer which is often malignancy. The majority of malignancy in Marjolin’s ucers are squamous cell carcinomas. Rarely described malignancies in Marjolin’s ulcers are basal cell carcinoma, melanoma, adenocarcinoma, liposarcoma, fibrosarcoma and osteogenic sarcoma.
The author of this article present a case of a 70-year-old Caucasian man who was admitted to the hospital because of Marjolin’s ulcer. The author performed a literature review on Marjolin’s ulcer diagnosis and treatment.
Marjolin’s ulcer is defined as a tumor which is arising from a chronic wound, scar or chronic inflammation (1, 2). It is a rare chronic cutaneous ulcer which is often malignancy (1, 2). The majority of malignancy in Marjolin’s ucers are squamous cell carcinomas. Rarely described malignancies in Marjolin’s ulcers are basal cell carcinoma, melanoma, adenocarcinoma, liposarcoma, fibrosarcoma and osteogenic sarcoma (3).
A 70-year-old Caucasian man was referred to the Department of Surgical Oncology Hospital Ministry of Internal Affairs with Warmia and Mazury Oncology Centre in Olsztyn due to Marjolin’s ulcer of the right tight (fig. 1). In an interview with the patient, he had the burn injury 15 years ago and from 3 years he observed tumor which was arising from this chronic wound. Marjolin’s ulcer in histopathologically examination was: squamous cell carcinoma G2. CT scan showed no infiltration carcinoma cells on important important nerve or vascular structures or bone. The patient had no any other symptoms, there was no history of weight loss and loss of appetite. The patient was treated chronically for hypertension and benign prostatic hyperplasia (BPH). He had no surgeries and there was no history of carcinoma in patient family. Blood test and other routine hematological examinations and biochemical tests were within normal limits.
Figure 1. Clinical photograph of Marjolin’s ulcer on the right tight from burn injury.
The chronic wound after burn injury had diameter 20 centimeters. In the central part of this wound was located Marjolin’s ulcer diameter 11 centimeters (fig. 2). Regional lymph nodes in palpable examination were not enlarged.
Figure 2. The chronic wound on the right tight had diameter 20 centimeters and in the central part of chronic wound was located Marjolin’s ulcer diameter 11 centimeters.
The patient was admitted to the Department of Surgical Oncology to wide local excision of Marjolin’s ulcer. The patient was informed about the possibility of treating Marjolin’s ulcer and possible complications associated with surgery. The patient refused surgery and decided that he wanted to undergo radiotherapy treatment. The patient was transferred for further treatment to the Department of Radiotherapy Hospital Ministry of Internal Affairs with Warmia and Mazury Oncology Centre in Olsztyn.
French surgeon Jean-Nicholas Marjolin first time described ulceration in a burn scar in 1828 (4). Dupuytren first time noted malignancy in „Marjolin’s ulcer” (5). DaCosta first time described forming malignant tumors inside „Marjolin’s ulcer” (6).
The mechanism of malignant transformation of Marjolin’s ulcer is still unclear (7). Some theories consider that the toxin, chronic irritation and inflammation, ultraviolet rays and environmental interaction affected the malignant transformation (7).
Powyżej zamieściliśmy fragment artykułu, do którego możesz uzyskać pełny dostęp.
Płatny dostęp tylko do jednego, POWYŻSZEGO artykułu w Czytelni Medycznej
(uzyskany kod musi być wprowadzony na stronie artykułu, do którego został wykupiony)
Płatny dostęp do wszystkich zasobów Czytelni Medycznej
zaakceptowano do druku: 2014-11-18
Adres do korespondencji:
General Surgery Consultant
Department of Surgical Oncology
Faculty of Medicine University of Warmia and Mazury
37 al. Wojska Polskiego, 10-228 Olsztyn, Poland
tel.: +48 505-818-126
e-mail: email@example.comNew Medicine 4/2014
Strona internetowa czasopisma New Medicine