Clinical Study on Marjoli's Ulcer

Hahn, Soo Bong; Kim, Dong Jun

Abstract

The Marjolin's ulcer is the malignant lesion developed in a burn scar or chronic fistula. Due to the low prevlalence of this lesion, there has been disagreement in its clinical features, methods of treatment, and prognosis. We evaluated 19 cases of patients who had been admitted to Severence Hospital from Jan. 1970 to Dec. 1958. The results were as follows : 1. The previous lesion was burn scar in 52% of the cases and fistula of chronic osteomyel-itis in 32%. 2. The mean latent period was 31.5 years. 3. The initial symptoms were increased pain(74%), discharge with foul odor(68%) and bleeding(58%). 4. Upon histological examination, all of the cases were squamous cell carcinoma. 5. The rate of recurrence of metastasis at time of diagnosis was 32%. 6. 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. 7. The time interval for local recurrence ranged from 6 months to 11 months(average 8. 8 months). In conclusion, the squauious cell carcinoma of the Marjolin's ulcer seems to have a worse prognosis than other squamous cell carcinoma and it requres aggressive treatment. The burn scar or chronic fistula that occured in elderly patients especially required more adequste treatment and close observation.