Demographic and histopathologic characteristics of Marjolin’s ulcers in Razi Hospital, Tehran, Iran: A 5-year survey

Background: Approximately 0.77% to 2% of cutaneous ulcers and post-burn scars will develop malignant degeneration. When squamous cell carcinoma (SCC) emerges in a chronic scar or ulcer, it often is referred to as Marjolin’s ulcer (MU). Methods: This cross-sectional study assessed demographic information and pathological features of MU in Razi Hospital during 2009 to 2014. We reviewed 5150 chronic scar/ulcer cases and found 30 MU cases. Results: Patients had an average age of 59.2±19.9 years. Most cases were males Among 30 cases of MU, well-differential SCC accounted for 43.3% of cases. Moderately-differentiated SCC comprised 13.3% of cases, whereas there was invasive SCC in 10% of MUs. Only 3.3% of patients showed poorly-differentiated SCC and 9 (30%) had undifferentiated SCC. The average latency between burn and malignancy was 32.4±18.5 years In the majority (90%) of cases, the initial injury was a burn. The lower and upper limbs comprised 53.3% and 26.7% of cases, respectively. There was one case with a history of melanoma. Among the 4 measured concurrent risk factors for malignancy, sun exposure was the most prevalent. Conclusion: Since there is a high possibility of SCC formation in burn lesions and other identical lesions, rapid follow-up and appropriate treatment in acute burn lesions is necessary.