Marjolin's ulcer: clinical and pathologic features of 83 cases and review of literature

BACKGROUND: Marjolin's ulcer is a rare, aggressive condition that arises on chronic skin lesions and diseases. Inthis article, we will report 83 cases of this disease. METHODS: Retrospectively, we retrieved 83 records of patients with cancer arising from chronic skin conditions.Data concerning demography, type of original skin insult, time interval between original lesion and cancer,cancer histology, and lymph node involvement were recorded. RESULTS: The mean age was 55.30 years (range: 21-90). There were 51 males (61.5%) and 32 females (38.5%).Foot was the most prevalent site of primary skin lesion (49.4%) followed by scalp (15.6%). Original skin insultswere burn (87.9%), osteomyelitis (2.4%), radiation (2.4%), electrical burn (1.2%), surgical scar (2.4%),pemphigus (1.2%), bite (1.2%), and bed sore (1.2%). Histologic diagnosis were well differentiated SCC(38.6%), SCC, differentiation not reported (24.1%), moderately differentiated SCC (13.2%), BCC (9.6%), poorlydifferentiated SCC (6.0%), melanoma (2.4%), verrucous carcinoma (2.4%), MFH (1.2%), mucoepidermoidcarcinoma (1.2%), and leiomyosarcoma (1.2%). Most of the cases occurred more than 20 years after the initialskin insult. There were 6 (7.2%) cases that developed within 1 year (acute Marjolin's Ulcer). Forty three patients(69.3%) had palpable regional lymph nodes. CONCLUSION: Data in this series were in confirmation with many other reports. Marjoln's ulcer should be consideredas a significant post-skin injury complication.