Tobin Chase, Sanger James R
Eastern Virginia Medical School, Norfolk, VA; email:
Medical College of Wisconsin, Milwaukee, WI.
Wounds. 2014 Sep;26(8):248-54.
A Marjolin's ulcer describes malignant degeneration in any chronic wound. The majority of cases arise in burn scars and are often latent for decades.
This case series presents 6 patients with an average age of 63 years with Marjolin's ulcers (both acute and chronic). A review of the literature was also undertaken. These cases underscore the aggressive course and poor prognosis associated with Marjolin's ulcers and the importance of recognizing the potential for malignant transformation of a chronic wound.
In the reported cases, the ulcers were found on the upper and lower extremity, flank, and over the sacrum, emphasizing the propensity of these ulcers to arise in nearly any location. Squamous cell carcinoma is the most prevalent malignancy identified in Marjolin's ulcers and was confirmed in all patients in this study. Patients underwent surgical resection, and all patients eventually succumbed to the disease.
Based on observations and a review of the literature, early detection and aggressive management with wide local excision and prompt coverage yield optimal results when treating patients with Marjolin's ulcers.
Marjolin溃疡是指任何慢性伤口发生的恶性退变。大多数病例发生于烧伤瘢痕，且通常潜伏数十年。
本病例系列报告了6例平均年龄63岁的Marjolin溃疡患者（包括急性和慢性）。同时进行了文献回顾。这些病例强调了Marjolin溃疡的侵袭性病程和不良预后，以及认识慢性伤口发生恶性转化可能性的重要性。
在报告的病例中，溃疡见于上肢、下肢、侧腹和骶部，强调了这些溃疡几乎可发生于任何部位的倾向。鳞状细胞癌是Marjolin溃疡中最常见的恶性肿瘤，本研究中的所有患者均得到确诊。患者接受了手术切除，但最终均死于该疾病。
基于观察和文献回顾，对于Marjolin溃疡患者，早期发现并采用广泛局部切除和及时覆盖的积极治疗方法可取得最佳效果。
