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Marjolin ulcers: secondary carcinomas in chronic wounds
R J Esther1, L Lamps, H S Schwartz
1Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt Unviersity, Nashville, TN 37232-2550, USA.
Journal of the Southern Orthopaedic Association
|July 23, 2002
Summary
Marjolin ulcers, malignant tumors from chronic wounds like pressure sores or burn scars, behave aggressively. Early recognition and staging are crucial for cure, as lymph node metastases indicate a grave prognosis.
Area of Science:
- Oncology
- Dermatology
- Surgical Pathology
Background:
- Marjolin ulcers are malignant carcinomas developing in chronic wounds.
- These aggressive tumors commonly arise from pressure sores or burn scars.
Observation:
- A retrospective study identified six patients with chronic wound ulcers that transformed into carcinoma.
- The average latency period from ulceration to malignancy diagnosis was 30 years.
- Affected wounds were located on the pelvis or flank.
Findings:
- High-grade tumors with positive lymph node metastases had a grave prognosis.
- Four patients with nodal metastases died from systemic disease.
- Sinus tract degeneration in osteomyelitis was excluded from this study.
Implications:
- Early recognition and accurate staging of Marjolin ulcers are essential for improving patient outcomes.
- Aggressive surgical management is indicated for these malignant transformations.
- Understanding the latency and location can aid in early detection and treatment strategies.
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