Clinical characteristics and therapeutic analysis of 51 patients with Marjolin's ulcers

Shen,Rui; Zhang,Jinming; Zhang,Fenggang; Du,Yongjun; Liang,Weiqiang; Xu,Lusheng; Du,Xueliang; Chen,Ping; Chen,Xiaodong

doi:10.3892/etm.2015.2699

Clinical characteristics and therapeutic analysis of 51 patients with Marjolin's ulcers

Authors:
- Rui Shen
- Jinming Zhang
- Fenggang Zhang
- Yongjun Du
- Weiqiang Liang
- Lusheng Xu
- Xueliang Du
- Ping Chen
- Xiaodong Chen
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Affiliations: Department of Plastic Surgery, The Second Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510120, P.R. China, Department of Plastic Surgery, The Affiliated Foshan Hospital of Sun Yat‑sen University, Foshan, Guangdong 528000, P.R. China
Published online on: August 24, 2015 https://doi.org/10.3892/etm.2015.2699
Pages: 1364-1374
Copyright: © Shen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Marjolin's ulcers, which are epidermoid carcinomas arising on non‑healing scar tissue, may be of various pathological types, including squamous cell carcinoma. The pathogenesis of squamous cell carcinoma arising in an ulcer differs from that of the primary cutaneous squamous cell carcinoma. This squamous cell carcinoma is aggressive in nature, and has a high rate of metastasis. Between January 2001 and September 2013, 51 patients with Marjolin's ulcers were admitted to the Departments of Plastic Surgery of the Affiliated Foshan Hospital and the Second Affiliated Hospital of Sun Yat‑sen University. The ulcers included 43 cases of squamous cell carcinoma, six of melanoma, one of basal cell carcinoma and one of epithelioid sarcoma. The clinical data of these patients were retrospectively analyzed. Patients were followed until mortality. Among the patients with squamous cell carcinoma, 30.23% exhibited sentinel lymph node metastasis and 11.63% had distant metastasis. Among the patients with melanoma, 66.67% had sentinel lymph node metastasis and 33.33% had distant metastasis. Sentinel lymph node metastasis was successfully detected in 11 patients with Marjolin's ulcer using 18F‑fluorodeoxyglucose positron emission tomography‑computed tomography and B‑mode ultrasound guided biopsy. Squamous cell carcinoma was often treated by extended resection and skin grafting or skin flap repair. Patients with deep, aggressive squamous cell carcinoma of an extremity and sentinel lymph node metastasis underwent amputation and lymph node dissection. This treatment was also used for melanoma type Marjolin's ulcers.

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