Marjolin's Ulcers: A Review
Keywords:
Marjolin's Ulcers, Review of LiteratureAbstract
Background: Marjolin's ulcers though thought to be rare have been reported to have a higher incidence in sub-Saharan Africa. These tumors typically run an aggressive course with a poor prognosis. Late presentation has been reported to be typical of these cancers and some of the reasons adduced for this, are difficulties in both clinical and pathological diagnosis. This review therefore aims at enlightening the medical community on Marjolin's ulcers with a view to improving early recognition, treatment and outcome.
Method: Literatures on marjolin's ulcers were sourced from available journals and internet based searches using Pubmed, Medline and Google search.
Results: The incidence of Marjolin's ulcers appears higher in developing countries. First recognized in the first century AD, a lot is yet to be understood about the evolution of these cancers. Late presentation still remains a feature of this pathology even in recent times. Prognosis improves drastically with early recognition and treatment.
Conclusion: The key to improving outcome in Marjolin's ulcers is early recognition and adequate treatment.
References
Treves N, Pack GT: The development of cancer in burn scars. Surg Gynecol Obstet 1930, 51:749-782.st
Marjolin JN. Ulcers. Dictionaire de Medicine. Vol.21, 1ed. Paris: Bechet Jeune, 1828: 46
Applebaum J, Burrows WM, Greenway HJ. Acute Marjolin's ulcer. J Assoc Mil Dermatol 1985;11: 57-61
Nancarrow JD. Cicartrical cancer in South-West England: a regional regional plastic surgery unit's experience over a 20 tear period. Br J Surg. 1983:70;205-208
Cruickshank AH, Connel EM, Miller DG. Malignancy in scars, chronic ulcers and sinuses. J Clin Pathol 1963;16:573-80
Smith J, Mello LF, Nogueira Neto NC, et al. Malignancy in chronic ulcers and scars of the leg (Marjolin's ulcer): a study of 21 patients. Skeletal Radiol 2001;30(6):331-7.
Castillo J, Goldsmith HS. Burn scar carcinoma. Cancer J. Clin. 1968;18:140-142
Sisrat MV, Shrikhande SS. Histochemical studies on squamous cell carcinomas of the skin arising in burn scars with special reference to histogenesis. Indian J. Cancer. 1967;3:157-169
Novick M, Gard DA, Hardy SB, Spira M. Burn scar carcinoma: A review and analysis of 46 cases. The Journal of Trauma. 1977;10:809-817.
Engler HS: Cancer arising in scars of old burns. J Med Assoc Ga 1968; 57:145
Nthumba PM. Marjolin's ulcers in sub Saharan Africa. World J Surg. 2010;34:
Asuquo ME Ikpeme IA, Bassey EE, Ebughe G. Squamous Cell Carcinoma in South-Eastern Equatorial Rain Forest in Calabar, Nigeria. Eplasty. 2009; 9: e53
Callam MJ, Harper DR, Dale JJ, et al. Chronic ulcer of the leg: clinical history. Br Med J (Clin Res Ed) 1987;294(6584):1389-91.
Lawrence REA, Carcinomas arising in burn scars. Surg Gynaecol. Obstet. 1952; 95:579-588
Duncan KO, Leffell DJ. Epithelial precancerous lesions. In: Freedberg IM, Eisen AZ, Wolff K. Fitzpatrick's dermatology in general medicine. 6 ed. New York: Mc Graw-Hill; 2003. P.719-36.
Dupree MT, Boyer JD, Cobb MW: Marjolin's ulcer arising in a burn scar. Cutis 1998, 62:49-51.
Horton CE, Crawford HH, Love HG, Leffler RA. The malignant potential of Burn scar. Plast Reconstr Surg 1958;22:348-53.
Tenopyr J, Silverman I. The relation of chronic varicose ulcer to epithelioma. Ann Surg 1932;95:7548
Arons MS, Rodin AE, Lynch JB, Lewis SR, Blocker TG Jr: Scar tissue carcinoma. Part II: an experimental study with special reference to burn scar carcinoma. Ann Surg 1966, 163:445-460.
Malheiro E., Pinto A., Choupina M., Barroso L., Reis J., Amarante J. Marjolin's ulcer of the scalp: A case report and literature review. Ann of Burn and fire disaster. 2001;14:
Lee SH, Shin MS, Kim HS: Somatic mutations of Fas (Apo-1/CD95) gene in cutaneous cell carcinomas arising from a burn scar.J Invest Dermatol 1999, 114:122-126
Harland DL, Robinson WA, Franklin WA: Deletion of the p53 gene in a patient with aggressive burn scar carcinoma. J Trauma 1997, 42:104-107.
Kowal-Vern A, Criswell BK: Burn scar neoplasms: A literature review and statistical analysis. Burns 2005, 31:403-413.
Nthumba PM. Marjolin's ulcers: theories, prognostic factors and their peculiarities in spina bifida patients.World Journal of Surgical Oncology 2010, 8:108
McLeod JM: Burns and their treatment. London, Oxford Univ Press, 1918, p 15
Stauffer H: Zeistschr Krebsforsch . 1929;28:418
Simons MA, Edwards JM, Nigam A. Marjolin's ulcer presenting in the neck. J Laryngol Otol 2000;114:980-2.
MohamedSI, AbdullahBJJ, SinghDA, HengKS. CT appearances of Marjolin's ulcer in the left gluteal region ofa young man. Biomed Imaging Interv J 2006; 2:e26
Nelzen O, Bergqvist D, Lindhagen A. Venous and non-venous leg ulcers: clinical history and appearance in a population study. Br J Surg 1994;81(2):182-7
Bowers RF, Young JM: Carcinoma arising in scars, osteomyelitis and fistulae. Arch Surg. 1960;80:564.
Esther RJ, Lamps L, Schwartz HS: Marjolin ulcers: secondary carcinomas in chronic wounds. J South Orthop Assoc 1999, 8:181-187.
Nthumba PM. Marjolin's ulcers: theories, prognostic factors and their peculiarities in spina bifida patients.World Journal of Surgical Oncology 2010, 8:108
Baldursson BT, Hedblad MA, Beitner H, Lindelöf B. Squamous cell carcinoma complicating chronic venous leg ulceration: a study of the histopathology, course and survival in 25 patients. Br J Dermatol. 1999;140:1148-52.
Kontochristopoulos G, Kyriakis K, Symeonidou S, Katsiboulas V, Aroni K, Panteleos D, et al. Squamous cell carcinoma in chronic trophic ulcers of leprosy patients. J Eur Acad Dermatol Venerol. 2000;14:222-36
Baldursson B, Sigurgeirsson B, Lindelöf B. Venous leg ulcers and squamous cell carcinoma: a large-scale epidemiological study. Br J Dermatol. 1995;133:571-4.
Bosch RJ, Gallardo MA, Ruiz Del Portal G, Sanchez P, Arce MF, Herrera E. Squamous cell carcinoma secondary to recessive dystrophic epidermolysis bullosa: report ofeight tumours in four patients. J Eur Acad Dermatol Venerol. 1999;13:198-204. III
Vanessa O. Zagne Bauk; Aline Mesquita Assunção; IIIIIRenata Ferreira Domingues; Nurimar C. Fernandes; IVIVTullia Cuzzi Maya; Juan Piñeiro Maceira Marjolin's ulcer: a twelve-case report Anais Brasileiros de DermatologiaAn. Bras. Dermatol. 2006. 81
Celikoz B, Demiriz M, Selmanpakoglu N. A shorter lag period of mesenchymal malignancyon Marjolin's ulcer. Burns 1997;23:72-4
Das S, Roy AK, Maiti A. Marjolin ulcer with multifocal origin. Indian J Dermatol 2009;54:14-5
Phillips TJ, Salman SM, Bhawan J, Rogers GS: Burn scar carcinoma. Diagnosis and management. Dermatol Surg 1998, 24:561-565
Kirkham N. Tumours and cysts of the epidermis. In: Lever WF, Lever GS. Lever's histopathology of the skin. 8 ed. Philadelphia: Lippincott-Raven; 1997. p. 685-746.
Ames FC, Hicky RC. Squamous cell carcinoma of the skin of the extremeties. Int Adv Surg Oncol. 1980;3:17999.
Abdolazim Ghalambor. Marjolin ulcer: How much ofsafety margin needs resection along marjolin ulcer squamous cell carcinoma in recurrence cases. Pak J Med Sci May - June 2007 Vol. 23 No. 3 394-397
Fleming M.D., Hunt J.L., Purdue G.F. et al.: Marjolin's ulcer: A review and re-evaluation of a difficult problem. J. Burn Care Rehabil., 11: 460-9, 1990.
Gross ND, Monroe M. Skin cancer: squamous cell carcinoma. 2009 Available at: http://emedicine.medscape.com/article/870430-overview. Accessed April 15, 2011
Barr LH, Menard JW. Marjolin's ulcer: the LSU experience. Cancer 1983;52:173-5.
Hill bb, Sloan DA, Lee EY, McGrath PC, Kennady DE. Marjolin's ulcer of the foot caused by non-burn trauma. South Med J 1996;89:707-10
Arons MS, Rodin AE, Lynch JB, Lewis SR, Blocker TG Jr: Scar tissue carcinoma. Part I: A clinical study with special reference to burn scar carcinoma. Ann Surg 1965, 161:170-188.
Bostwick J, Pendergrast WJ, Vasconez LO: Marjolin's ulcer: an immunologically priviledged tumor? Plast Reconstr Surg 1975, 57:66-69
Moller R, Reymann F, Hou-Jensen K. Metastases in dermatological patients with squamous cell carcinoma. Arch Dermatol 1979;115:703-5
Konigova R, Rychterova V. Marjolin's ulcer. Acta Chir Plast 2000;42:91-4
Alcolado JC, Ray K, Baxter M, Edwards CW, Dodson PM. Mlignant change in dermatitis artefacta. Postgrad Med J. 1993;69:648-50
Friedman HI, Cooper PH, Wanebo HJ: Prognostic and therapeutic use of microstaging of cutaneous squamous cell carcinoma of the trunk and extremities. Cancer 1985, 56:1099-1105.
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