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Surgery Carcinogenesis 7aff3da9

Carcinoma developed in a scar is called:

A
Sarcoma
B
Adenocarcinoma
C
Dermoid tumor
D
Marjolins ulcer
High-Yield Explanation
Ans. (d) Marjolin's ulcerRef: Bailey & Love 26th ed./918* Marjolins ulcer is a misnomer. It is a malignant degeneration arising within a pre-existing cicatrix or scar* Most commonly found in the lower extremity - especially the heel and plantar foot.* Causes:# As originally presented by Marjolin, to this day the leading cause is old burn scars.# The second most common association is malignant degeneration arising within osteomyelitic fistulae.# Other causes in decreasing order of frequency- secondary to venous insufficiency ulcers or pressure ulcers, scarring from lupus, amputation stumps, frostbite, vaccination sites, skin graft donor sites, scars, urinary fistulas, and radiation.* Marjolins ulcers are 3 times more likely in men than in women.* Average age of diagnosis is the fifth decade of life.* As a rule, normal healing should be exhibited within the first 2 to 3 weeks, and ulcers that repeatedly break down, do not respond to treatment and are chronic in nature, are suspicious for malignancy* Most commonly well-differentiated squamous cell tumors found but can be basal cell or melanoma* Duration of ulceration is directly proportional to chance of malignant transformation* Although there is no definitive treatment protocol, therapy generally involves wide local excision with skin grafting or amputation proximal to the lesion depending upon size.* Most widely accepted treatment/ most definitive option to treat the cancer and infection/ when the bone or joint is involved is amputation.

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