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Burn scar neoplasms: a literature review and statistical analysis
Areta Kowal-Vern1, Bryan K Criswell
1Sumner L. Koch Burn Center, Department of Trauma, John H. Stroger, Jr. Hospital of Cook County, 1901 West Harrison Street, Room 3229, Chicago, IL 60612, USA. akvern@comcast.net
Background:
Although squamous cell carcinoma (SCC) is the most common burn scar neoplasm, other neoplasms have also been reported.
Objective:
To compile the burn scar neoplasm cases in the literature and to analyze their frequency and demographic characteristics.
Materials And Methods:
Cases were obtained through literature searches.
Results:
There were 412 cases gleaned from 146 articles between 1923 and 2004. Seventy-one percent (293) of the tumors were squamous cell carcinoma, 12% (48) were basal cell carcinoma (BCC), 6% (23) were melanoma, 5% (21) were sarcoma, 4% (16) were other neoplasms, 1% (6) were squamo-basal cell carcinoma, and 1% (5) squamous cell-melanoma. The mean age at tumor diagnosis was 50 years, the mean age at the time of burn injury was 20 years, the mean latency interval was 31 years. Only 5% of the reported cases were excised and grafted at the time of injury (p<0.001). BCC occurred at a significantly later age compared to SCC and sarcoma groups (p<0.02) and had a shorter latency period compared to SCC and sarcoma groups (p<0.004) and melanoma (p<0.008). Local recurrence was present in 16% of the cases, while regional lymph node involvement was seen in 22% of the cases and distant metastases was present in 14% of the patients. The mortality rate was 21%.
Conclusions:
Although the main burn scar neoplasm was SCC, other neoplasms contributed to the morbidity and mortality of burn patients. Excision and grafting of deep burns, and close follow-up of non-healing ulcerated burn scars is essential for the prevention and early detection of burn scar neoplasms.
