Burn scar carcinoma.
BACKGROUND
Since Jean-Nicolas Marjolin reported carcinoma arising in post-traumatic scars in 1828, the term 'Marjolin ulcer' has been applied to malignant changes in burn scars. Although many papers have been published already in this field, there are few reports from Oriental people.


METHODS
From 1989 to 2008, there were 11 cases noted as burn scar carcinoma in Chang Gung Memorial Hospital. Ten were reported as squamous cell carcinoma (SCC) and the one was verrucous carcinoma. Most of the cases occurred in the extremities (10/11).


RESULTS
Ten cases underwent an operation initially with wide excision and skin graft or local flap for coverage. Forefoot amputation was performed in one patient. One patient received above-knee amputation and adjuvant therapy because recurrent verrucous carcinoma occurred 2 years later. One patient suffered from a new lesion 8 years later and another case had inguinal lymph node metastasis 8 months later. Five patients were lost to follow-up and six cases were tumor-free during the follow-up period. Most scar malignancies are SCC while other cell types are rarer.


CONCLUSIONS
The casual association between burn injuries and a later risk of basal cell carcinoma is questionable. Owing to poor prognosis in advanced scar cancer, the best treatment for scar carcinoma is to prevent the scar from developing repeated ulceration by performing aggressive initial burn wound care: early grafting by surgeons and daily scar care with regular follow-up for patients. This may be why a lower incidence has been noted in recent years.
Huang
Chun-Yuan
CY
LinKou Burn Center, Department of Plastic &amp; Reconstructive Surgery, Chang Gung Memorial Hospital and University, Taipei, Taiwan.
Feng
Chung-Ho
CH
Hsiao
Yen-Chang
YC
Chuang
Shiow Shuh
SS
Yang
Jui-Yung
JY
D000328:Adult; D002056:Burns / Q000150:complications*; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000601:surgery*; D018289:Carcinoma, Verrucous / Q000209:etiology / Q000601:surgery*; D002921:Cicatrix / Q000150:complications*; D005121:Extremities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000209:etiology / Q000601:surgery*; D016038:Skin Transplantation; D016896:Treatment Outcome; D055815:Young Adult