Long Zhongheng, Xie Weiguo
Institute of Burns, Wuhan City Hospital NO.3 & Tongren Hospital of Wuhan University, Wuhan 430060, China.
Institute of Burns, Wuhan City Hospital NO.3 & Tongren Hospital of Wuhan University, Wuhan 430060, China. Email:
Zhonghua Shao Shang Za Zhi. 2014 Dec;30(6):495-9.
Marjolin's ulcer is a rare malignancy arising from various forms of scars, mainly an old scar resulted from burn. The second most common origin is malignant degeneration arising from tissue within osteomyelitis fistulae. Not uncommonly, the lesions may arise secondary to ulcers due to venous insufficiency or pressure sores. The pathology of the majority of Marjolin's ulcer is a well-differentiated squamous cell carcinoma. The exact reason for an ulcer which undergoes a malignant transformation is unknown. The pathologic diagnosis is the gold standard. Surgery remains the preferred treatment after diagnosis is reached. Wide surgical excision with margins up to 2-3 cm has been suggested. The necessity of whether lymphatic dissection should be executed, or radiotherapy and chemotherapy following surgery is still in dispute. This article deals with the etiology of Marjolin's ulcer and its pathological grading, diagnosis, treatment, prognosis, and prevention, with a hope to provide some useful clinical information.
马乔林溃疡是一种罕见的恶性肿瘤,起源于各种瘢痕,主要是烧伤形成的陈旧瘢痕。第二常见的起源是骨髓炎瘘管内组织的恶性变。病变继发于静脉功能不全或压疮引起的溃疡并不少见。大多数马乔林溃疡的病理是高分化鳞状细胞癌。溃疡发生恶性转化的确切原因尚不清楚。病理诊断是金标准。确诊后手术仍是首选治疗方法。有人建议进行切缘达2 - 3厘米的广泛手术切除。是否应进行淋巴清扫,或术后是否进行放疗和化疗仍存在争议。本文探讨了马乔林溃疡的病因及其病理分级、诊断、治疗、预后和预防,以期提供一些有用的临床信息。