Massive Marjolin's ulcer in a burn graft site 46 years later

Marjolin's ulcers, or malignancy originating from burn scars, have been recorded in the literature since the first century AD (Ozek et al. Marjolin's ulcers arising in burn scars. J Burn Care Rehabil 2001;22:384-9). The majority of cases of Marjolin's ulcers occur in primary burn scar sites with few reported cases following secondary graft placement. We report a case of Marjolin's ulcer that developed in a 57-year-old man, 46 years after initial skin graft placement following a left lower extremity burn. The patient presented to us following diagnosis of squamous cell carcinoma of the verucous type lesion. Wide surgical excision was performed and a split thickness skin graft was applied. The postoperative course was uneventful and no recurrences have occurred. To our knowledge, this is the largest reported Marjolin's case recorded in the literature.