Marjolin’s ulcer - dual lymph node metastasis with cystic degeneration: a rare presentation
Keywords:
Marjolin’s ulcer, Squamous cell carcinoma, Lymph node metastasisAbstract
Marjolin’s ulcer is a malignant tumour developing in chronic skin lesions (burn scar, non-healing wound etc.), with a mean time period of 36 years after sustaining burns. Majority of cases reported are squamous cell carcinoma, occurring in males and involving the extremities. Surgery remains the first treatment of choice (resection with 2 cm safety margin of healthy skin for primary squamous cell carcinoma in Marjolin’s ulcers and 2.5 cm safety margin for recurrent cases). Recurrence after surgery and regional lymph node metastasis has been observed. We present a uncommon case in 55 year female with Marjolin’s ulcer following burns scar over left abdominal region, who presented as dual regional, ipsilateral axillary and inguinal lymph node metastasis with cystic degeneration.
References
Treves N, Pack GT. The development of cancer in burn scars. Surg Gynecol Obstet. 1930;51:749-82.
Marjolin JN. Ulcers. In: Marjolin JN, eds. Dictionaire de Medicine. 1st ed. Paris: Bechet Jeune; 1828: 46.
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;18:140-2.
Nancarrow JD. Cicartrical cancer in South-West England: a regional plastic surgery unit’s experience over a 20 year period. Br J Surg. 1983;70:205-8.
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 Burn Fire Disaster. 2001;14:39-43.
Novick M, Gard DA, Hardy SB, Spira M. Burn scar carcinoma: a review and analysis of 46 cases. J Trauma. 1977;10:809-17.
Nthumba PM. Marjolin’s ulcers in sub Saharan Africa. World J Surg. 2010;34(10):2272-7.
McLeod JM. Burns and their treatment. In: McLeod JM, eds. 1st ed. London: Oxford University Press; 1918: 15.
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.
Novick M, Gard DA, Hardy SB, Spira M. Burn scar carcinoma: a review and analysis of 46 cases. J Trauma. 1977;10:809-17.
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;163:445-60.
Abdolazim Ghalambor. Marjolin ulcer: how much of safety margin needs resection along Marjolin ulcer squamous cell carcinoma in recurrence cases. Pak J Med Sci. 2007 May-June;23(3):394-7.
Lifeso RM, Bull CA. Squamous cell carcinoma of the extremities. Cancer. 1985;55:2862-7.
Chalya PL, Mabula1 JB, et al. Marjolin’s ulcers at a university teaching hospital in North-western Tanzania: a retrospective review of 56 cases. World J Surg Oncol. 2012;10:38.
