Management Dilemma in a Large Fungating Squamous Cell Carcinoma Over a Marjolin’s Ulcer on the Chest Wall Coexisting With Severe Post-Burn Contracture of the Neck

Marjolin’s ulcer is a premalignant condition occurring over scars and chronically inflamed tissue. Squamous cell carcinoma is the most common malignancy associated with Marjolin’s ulcer. The progression of disease and metastasis is relatively slow due to scarring and meagre lymphatic and vascular supply over these scars. We present a case of a large fungating squamous cell carcinoma in a patent having a burn scar over his chest as well as having post-burn contracture of the neck, posing problems in management due to intubation issues. We managed him unconventionally with serial excision under local anesthesia and skin grafting of the wound.