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6 - Marjolins ulcer arising in scar tissue: Retrospective analysis of 1998-2005
Bülent Saçak, Semra Hacıkerim Karşıdağ, Uğur Tosun, Kemal Uğurlu, Damlanur Sakız, Lütfü Baş
Marjolins ulcer can be termed as a malignant tumor arising in chronic scar tissue. Although mostly seen in burn scars, it can occur in the presence of other chronic wounds. We present a total of 16 Marjolins ulcers of 15 patients treated in our clinic between 1998 and 2005. Patients had a mean age of 49.8 years and showed 67% male predominance. Lesions were located at the trunk, upper limbs and lower limbs.
12 cases presented with a tumor diameter less than 10 cm. Mean scar age was 36,12. Mean ulcer diameter was 8,56 cm. Initial lymphadenopathy was detected at 4 of our cases. His- topathologically, preoperative biopsies revealed dysplasia in 3 cases, carcinoma in situ in 2 cases, and epidermoid carcinoma in 11 cases. Resection followed by either skin grafting or local flaps were performed for all the patients. Surgical margins were applied as 2 cm for all cases except the cases with dysplasia, where surgical margins were applied as 1 cm. Six of the cases were gone under regional lymph node dissection simultaneously with the resection. Two of the cases took further radiotheraphy. Except the case with tumor at two distinct locations, no reccurence was seen at the follow-ups. Two cases were lost with metastasis.
Keywords: Marjolins ulcer, epidermoid carcinoma
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