Marjolin's ulcer revisited--basal cell carcinoma arising from grenade fragments? Case report and review of the literature.
BACKGROUND
Marjolin's ulcer is a rare and often aggressive cutaneous malignancy arising in previously traumatized or chronically inflamed skin.


METHODS



METHODS
A 79-year-old World War II veteran developed basal cell carcinoma (BCC) at the site of a war wound. The tumour developed in relation to several metal grenade fragments. With a disease-free interval of 61 years between injury and onset of complications the patient had one of the longest latency periods of tumour development described so far.


RESULTS
Review of the literature reveals only five cases of relation between grenade fragments and malignancy formation. Presence of foreign bodies has been described as possible aetiology for malignancy development. Explosives and additives contain several mutagenic and tumourigenic substances. We hypothesize a causal connection between the grenade fragments and the development of BCC. Considering the long period of latency between injury and tumour development we suggest grenade injury with left fragments in soft tissue to be a new origin of Marjolin's ulcer.
Rieger
Ulrich M
UM
Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland. riegeru@uhbs.ch
Kalbermatten
Daniel F
DF
Wettstein
Reto
R
Heider
Ilonka
I
Haug
Martin
M
Pierer
Gerhard
G
D000368:Aged; D002280:Basal Cell Carcinoma / Q000209:etiology*; D002921:Cicatrix / Q000150:complications*; D005547:Foreign Bodies / Q000150:complications; D006801:Humans; D008297:Male; D012867:Skin; D012878:Skin Neoplasms / Q000209:etiology*; D012883:Skin Ulcer / Q000209:etiology*; D014857:Warfare; D014948:Wounds, Gunshot / Q000150:complications*