Intraoperative cytological evaluation of Marjolin ulcers.
BACKGROUND
Marjolin ulcers are malignant neoplasia developing in chronic open wounds and pathological scars. A definitive diagnosis is made by histological examination of permanent sections. Frozen section biopsy has been widely used for intraoperative diagnosis and evaluation of surgical excision safety margins. This preliminary study aims to discuss the reliability of a simpler and faster method -- intraoperative cytology -- in the diagnosis of Marjolin ulcers.


METHODS
Touch or scrape smears of 76 Marjolin ulcers from 22 patients were assessed, and features were compared to the histological appearance of permanent sections.


RESULTS
Cytology revealed squamous cell carcinoma (SCC) in 45 ulcers from 11 patients. Histology confirmed SCC in 48 ulcers from 12 patients. No false-positive and one false-negative results were found. Cytology was found to have a 98.7% accuracy, 98% sensitivity and 100% specificity in the intraoperative diagnosis of Marjolin ulcers.


CONCLUSIONS
Cytology is a fast and reliable alternative in the intraoperative diagnosis of Marjolin ulcers.
Kakagia
Despoina
D
Department of Surgery, Thraki Medical Center, Alexandroupolis, Greece. despoinakakagia@yahoo.com
Tamiolakis
Demetrios
D
Grekou
Alexandra
A
Vavetsis
Spyros
S
Lambropoulou
Maria
M
Papadopoulos
Nikolaos
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017169:Neoplasms, Post-Traumatic / Q000473:pathology* / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome