Yonsei Med J.  1990 Sep;31(3):234-241. 10.3349/ymj.1990.31.3.234.

Clinical study of Marjolin's ulcer

• Hahn SB
• Kim DJ
• Jeon CH

• KMID: 1107341
• DOI: http://doi.org/10.3349/ymj.1990.31.3.234

Abstract

Marjolin's ulcer is the malignant lesion which develops in a burn scar or chronic fistula. Due to the low prevalence of this lesion, there has been disagreement regarding its clinical features, methods of treatment, and prognosis. We evaluated 19 cases of patients who had been admitted to Severance Hospital from Jan. 1970 to Dec. 1985. The results were as follows: The previous lesion was a burn scar in 52% of the cases and a fistula of chronic osteomyelitis in 32%. The mean latent period was 31.5 years. The initial symptoms were increased pain (74%), discharge with foul odor (68%) and bleeding (58%). Upon histological examination, all of the cases were squamous cell carcinoma. The rate of metastasis at the time of diagnosis was 32%. Of the 16 patients treated by surgery, local recurrence was noted in 4 cases. Three of these cases were patients who had been treated by excision and split thickness skin graft. The time interval for local recurrence ranged from 6 months to 11 months (average 8.8 months). In conclusion, the squamous cell carcinoma of marjolin's ulcer seems to have a worse prognosis than other squamous cell carcinomas and it requires aggressive treatment. The burn scar or chronic fistula that occurs in elderly patients especially requires more adequate treatment and close observation.

Keyword

Marjolin's ulcer

MeSH Terms

Adult
Aged
Burns/complications
Carcinoma, Squamous Cell/*epidemiology/etiology/pathology/therapy
Case Report
Cicatrix/complications
Combined Modality Therapy
Female
Fistula/complications
Human
Korea/epidemiology
Male
Middle Age
Neoplasm Metastasis
Neoplasm Recurrence, Local/epidemiology
Osteomyelitis/complications
Prognosis
Skin Neoplasms/*epidemiology/etiology/pathology/therapy