J Korean Burn Soc.  2022 Dec;25(2):46-49. 10.47955/jkbs.22.0013.

A Masked Marjolin Ulcer despite of Multiple Biopsies Performed at the Outpatient Clinic

• Lee YC
• Kim JH
• Chung CM
• Park MC

• KMID: 2536412
• DOI: http://doi.org/10.47955/jkbs.22.0013

Abstract

Marjolin ulcer (MU) is a rare occurrence of squamous cell carcinoma (SCC) in the location of a previous scar. Old thermal burn scars are the most common site of MU development. Due to the aggressive behavior causing metastasis more frequently, precise diagnose is essential. Treatment of choice is wide excision with a wider margin. Here in, we present a case, where there was a risk of misdiagnosing the carcinoma as benign, since multiple punch biopsies did not reveal the SCC. A high suspicion of cancer according to clinical correlation, patient history, and radiologic studies are recommended to reduce the risk of neglecting cancer. Even if no cancerous lesion is reported in the biopsy, treatment equivalent to that administered for cancers should be initiated in consideration of gross findings and the mechanism of injury. Though it is revealed to be benign lesion through postoperative biopsy, it must be resected due to its precancerous characteristic.

Keyword

Marjolin ulcer; Skin cancer; Squamous cell carcinoma; Thermal burn; Lower extremity