J Korean Bone Joint Tumor Soc.  2012 Jun;18(1):1-6. 10.5292/jkbjts.2012.18.1.1.

Outcomes of Treatment for Squamous Cell Carcinoma Originating as a Marjolin's Ulcer

• Kim JK
• Yu CE
• Kim JR

• KMID: 1438397
• DOI: http://doi.org/10.5292/jkbjts.2012.18.1.1

Abstract

PURPOSE
The purpose of this study was to analyze the results of treatment and prognosis of Marjolin's ulcer compared with primary squamous cell carcinoma.
MATERIALS AND METHODS
Fourteen patients treated for Marjolin's ulcer were analyzed. Twenty patients with primary squamous cell carcinoma treated during the same time period was the control group. Mean age was 61.2 years. There were 24 males and 10 females. The locations, TNM stages, histological grades, recurrence, metastasis, and survival rate were analyzed and compared between two groups.
RESULTS
The mean follow-up period was 54.8 months (range, 12-168 months). Local recurrences were found in 6 cases, 5 ones in Marjolin's ulcer patients, and one case in primary squamous cell carcinoma patients. The mean time interval between the initial presentation and occurrence of local recurrences was 9 months (range, 2-20 months). There were 6 metastases. 2 (14.3%) metastases were found in Marjolin's ulcer patients, and 4 (20.0%) metastases in primary squamous cell carcinoma patients. Total events (metastasis or local recurrence) were found in 10 pateients, 6 of them in Marjolin's ulcer group, and the remaining four in primary group. 5-year disease-free survival rate was 64.3% in Marjolin's ulcer group and 95.0% in primary squamous cell carcinoma group.
CONCLUSION
Squamous cell carcinomas originating as Marjolin's ulcers revealed higher recurrence rate and lower survival rate despite of aggressive treatment. Therefore, new treatment modalities should be developed for improving outcomes.

Keyword

Marjolin's ulcer; squamous cell carcinoma; treatment; prognosis

MeSH Terms

Carcinoma, Squamous Cell
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Neoplasm Metastasis
Prognosis
Recurrence
Survival Rate
Ulcer

Figure

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  Figure 1 Marjolin ulcer showed significantly lower continuous disease free survival (p<0.05).

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  Figure 2 (A) 44 years-old male showed squamous cell carcinoma with Majoiln ulcer on forearm with 40 year latent period after burn injury. (B) Sagittal T2 weighted MRI showed diffuse infiltration of the subcutaneous layer. (C) 6 months later after A/E amputation and axillary LN dissection, squamous cell carcinoma recurred on axillary area. Wide marginal resection and chemotheraphy was done. (D) Forequarter amputation was done. (E) Skin graft from both thigh and chemotheraphy was done. (F) 2months after forequarter amputation, squamous cell carcinoma was recurred on previous skin graft. 2 month after lung metastasis was occurred and patient expired.

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