Marjolin's ulcer
Encyclopedia
Marjolin's ulcer refers to an aggressive ulcerating squamous cell carcinoma
presenting in an area of previously traumatized
, chronically inflamed, or scarred skin. They are commonly present in the context of chronic
wound
s including burn injuries
, venous ulcer
s, ulcers from osteomyelitis
, and post radiotherapy scars.
The term was named after French
surgeon
, Jean-Nicolas Marjolin
, who first described the condition in 1828. The term was later coined by J C De Costa.
tissue), and absence of lymph
atic spread due to local destruction of lymphatic channels.
, the tumour is a well-differentiated
squamous cell carcinoma. This carcinoma is aggressive in nature, spreads locally and is associated with a poor prognosis
.
40% occur on the lower limb and the malignant change is usually painless. This malignant change of the wound happens a long time after initial trauma usually 10–25 years later
specimens obtained should be taken from both the centre and margin of lesion
, as the central ulcerated deposits may be necrotic
.
of the lesion
; typically a 1 cm margin all around is required.
Squamous cell carcinoma
Squamous cell carcinoma , occasionally rendered as "squamous-cell carcinoma", is a histologically distinct form of cancer. It arises from the uncontrolled multiplication of malignant cells deriving from epithelium, or showing particular cytological or tissue architectural characteristics of...
presenting in an area of previously traumatized
Physical trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...
, chronically inflamed, or scarred skin. They are commonly present in the context of chronic
Chronic (medicine)
A chronic disease is a disease or other human health condition that is persistent or long-lasting in nature. The term chronic is usually applied when the course of the disease lasts for more than three months. Common chronic diseases include asthma, cancer, diabetes and HIV/AIDS.In medicine, the...
wound
Wound
A wound is a type of injury in which skin is torn, cut or punctured , or where blunt force trauma causes a contusion . In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.-Open:...
s including burn injuries
Burn (injury)
A burn is a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction. Most burns affect only the skin . Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured...
, venous ulcer
Venous ulcer
Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs. They are the major cause of chronic wounds, occurring in 70% to 90% of chronic wound cases...
s, ulcers from osteomyelitis
Osteomyelitis
Osteomyelitis simply means an infection of the bone or bone marrow...
, and post radiotherapy scars.
The term was named after French
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
, Jean-Nicolas Marjolin
Jean-Nicolas Marjolin
Jean-Nicolas Marjolin was a French surgeon and pathologist born in Ray-sur-Saône, Haute-Saône. His name is associated with a malady known as Marjolin's ulcer....
, who first described the condition in 1828. The term was later coined by J C De Costa.
Appearance
Slow growth, painlessness (as the ulcer is usually not associated with nerveNerve
A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...
tissue), and absence of lymph
Lymph
Lymph is considered a part of the interstitial fluid, the fluid which lies in the interstices of all body tissues. Interstitial fluid becomes lymph when it enters a lymph capillary...
atic spread due to local destruction of lymphatic channels.
Characteristics
HistologicallyHistology
Histology is the study of the microscopic anatomy of cells and tissues of plants and animals. It is performed by examining cells and tissues commonly by sectioning and staining; followed by examination under a light microscope or electron microscope...
, the tumour is a well-differentiated
Grading (tumors)
In pathology, grading is a measure of the cell appearance in tumors and other neoplasms. Some pathology grading systems apply only to malignant neoplasms ; others apply also to benign neoplasms. The neoplastic grading is a measure of cell anaplasia in the sampled tumors arising from the...
squamous cell carcinoma. This carcinoma is aggressive in nature, spreads locally and is associated with a poor prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...
.
40% occur on the lower limb and the malignant change is usually painless. This malignant change of the wound happens a long time after initial trauma usually 10–25 years later
Diagnosis
Wedge biopsy is the favored method of diagnosis. TissueBiological tissue
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
specimens obtained should be taken from both the centre and margin of lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
, as the central ulcerated deposits may be necrotic
Necrosis
Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...
.
Treatment
Treatment is usually surgical, with a wide excisionExcision
Excision is the alias of Jeff Abel, a dubstep DJ and music boss from British Columbia, Canada. He frequently works with fellow Canadian dubstep producers Datsik and Downlink. As one of the first dubstep producers and DJs in North America, he has played a significant role in the genre's growth in...
of the lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
; typically a 1 cm margin all around is required.
External links
- http://it.wikipedia.org/wiki/Carcinoma_squamo-cellulare_di_Marjolin :it:Carcinoma squamo-cellulare di Marjolin