Adhikari Dibij, Pant Sobin, Mishra Amit Kumar, Thapa Anup, Sharma Samit
Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu 44600, Nepal.
Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu 44600, Nepal.
Int J Surg Case Rep. 2025 Mar;128:111004. doi: 10.1016/j.ijscr.2025.111004. Epub 2025 Jan 31.
Marjolin ulcer (MU) is a rare malignancy that arises in chronic burn scars. The malignant transformation rate of burn scars into MU is less than 2 %. While the extremities are the most common site, MU in the perineal region is exceptionally rare, accounting for only 2.1 % of cases. This case describes a MU that developed in a neglected perineal burn scar after latency of 40 years.
A 45-year-old female presented with a 3-month history of an itchy, painful ulceroproliferative mass in the groin. She had sustained a flame burn at age five. The mass caused discomfort and difficulty in walking. The patient underwent wide local excision and skin grafting. Histopathology confirmed well-differentiated squamous cell carcinoma. The postoperative recovery was uneventful with nearly 100 % graft take.
MU is an aggressive malignancy due to chronic irritation of burn scars, with an average latency of 30-35 years. Proper wound care and early surgical management of burns are essential for prevention. However, in developing countries, limited access to healthcare and societal stigma associated with burns-especially in sensitive areas like the perineum-lead to delayed treatment. This neglect can result in chronic scar contractures and eventual malignant transformation, as observed in this case.
MU in perineal scars is rare, often resulting from delayed treatment due to societal stigma. Prevention should focus on timely burn management, including excision and grafting. Efforts should raise awareness, reduce stigma, and promote early intervention to improve outcomes and prevent complications from chronic wounds.
马乔林溃疡（MU）是一种罕见的恶性肿瘤，发生于慢性烧伤瘢痕。烧伤瘢痕恶变为MU的发生率低于2%。虽然四肢是最常见的发病部位，但会阴区的MU极为罕见，仅占病例的2.1%。本病例描述了一例在被忽视的会阴烧伤瘢痕中潜伏40年后发生的MU。
一名45岁女性，腹股沟出现瘙痒、疼痛的溃疡增生性肿物3个月。她5岁时曾遭受火焰烧伤。该肿物引起不适和行走困难。患者接受了广泛局部切除和植皮手术。组织病理学证实为高分化鳞状细胞癌。术后恢复顺利，植皮成活率近100%。
由于烧伤瘢痕的慢性刺激，MU是一种侵袭性恶性肿瘤，平均潜伏期为30 - 35年。适当的伤口护理和烧伤的早期手术处理对预防至关重要。然而，在发展中国家，获得医疗保健的机会有限以及与烧伤相关的社会耻辱感——尤其是在会阴等敏感部位——导致治疗延迟。如本病例所示，这种忽视可导致慢性瘢痕挛缩并最终发生恶性转化。
会阴瘢痕中的MU罕见，通常是由于社会耻辱感导致治疗延迟所致。预防应侧重于及时的烧伤处理，包括切除和植皮。应努力提高认识、减少耻辱感并促进早期干预，以改善预后并预防慢性伤口的并发症。
