Surgery: Current Research

ISSN - 2161-1076


Marjolin’s Ulcer: Experience from a Developing Country

Sanjay KY, Chandan KJ, Gautam C, Dipendra KS, Abhinav A and Satish K

Introduction: Marjolin’s ulcer (MU) is a rare entity in developed countries, but is relatively common in developing countries due to use of traditional methods of cooking and lack of infrastructure for skin grafting of burn scars. This study was intended to describe the clinicopathologic profile and evaluate the treatment outcome of this condition in our setting.

Methods: This was a retrospective study of all histologically confirmed cases of MU, presenting to us from March 2011 to February 2014. Patients with metastatic disease at presentation and those having a follow up of less than 12 months were excluded.

Results: 123 patients were identified and 29 were excluded. Burn was the most common inciting factor (93.6%) and lower limb was the most common site (55.3%) of origin of MU. The mean duration between primary insult and MU was 12.0 ± 4.3 years. 74.5% patients presented with ulcers >5 cm in size. 16% had lymph node metastasis and 16.3% had distant metastasis at presentation. All but 3.2 patients were treated by wide local excision. 19.1% patients developed local recurrence and 6.4% developed distant metastasis during follow up (mean 30.0 ± 9.2 months).

Conclusion: Marjolin’s ulcers are not rare in our setting and commonly occur in burn scar that was not skin grafted and left to heal secondarily. The most common site of MU is lower limb and the most common histology is SCC. Patients with tumor larger than 5 cm are more prone to have recurrence and grade III SCC are at more risk of developing distant metastasis.