New onset squamous cell carcinoma in previous split-thickness skin graft donor site

Marjolin' s ulcer, an aggressive ulcerating squamous cell carcinoma, is a well-known phenomenon that occurs in chronically inflamed or scarred tissue; however, squamous cell carcinoma arising in the acute setting after tissue trauma - specifically autograft donor harvest sites for burns - is a rare, but notable event.

This case series describes three instances of squamous cell carcinoma diagnosed in split-thickness skin graft donor sites in the immediate post-operative period. Charts were reviewed in detail after at least 9 months follow-up from identification of the tumor. Detailed descriptions of each case are included. A discussion of the literature on this rare entity is included as well.

In the three cases discussed, all were characterized clinically as painful masses arising in a recently healed donor site. Two were managed surgically with adherence to oncologic principals. One lesion regressed or fell off spontaneously. With at least 9 months follow-up, there was no evidence of recurrence.

Very few cases of acute neoplasm in donor sites have been described in the literature. Presently, there is no dominant theory as to how these lesions arise; however, this is an entity that burn care providers, world wide should be aware of, with a low threshold for oncologic evaluation if suspected.