Marjolin's Tumor Complicating Chronic Periprosthetic Infection of a Total Knee Arthroplasty

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Abstract

Marjolin's tumor is a term used to describe a malignancy developing in the setting of a chronic wound, infection, or other tissue subject to chronic inflammatory changes. These malignancies usually present after many years of chronicity, and can range from lower grade basal cell carcinomas to high-grade sarcomas. We present the case of a squamous cell carcinoma that developed within a chronic periprosthetic infection of a total knee arthroplasty of 7 years duration. The intra-articular location, association with an orthopaedic implant, and brief latency period are all unique features of this case.

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Burn scar neoplasms: a literature review and statistical analysis.

Areta Kowal-Vern, B S Criswell (2005)

Although squamous cell carcinoma (SCC) is the most common burn scar neoplasm, other neoplasms have also been reported. To compile the burn scar neoplasm cases in the literature and to analyze their frequency and demographic characteristics. Cases were obtained through literature searches. There were 412 cases gleaned from 146 articles between 1923 and 2004. Seventy-one percent (293) of the tumors were squamous cell carcinoma, 12% (48) were basal cell carcinoma (BCC), 6% (23) were melanoma, 5% (21) were sarcoma, 4% (16) were other neoplasms, 1% (6) were squamo-basal cell carcinoma, and 1% (5) squamous cell-melanoma. The mean age at tumor diagnosis was 50 years, the mean age at the time of burn injury was 20 years, the mean latency interval was 31 years. Only 5% of the reported cases were excised and grafted at the time of injury (p<0.001). BCC occurred at a significantly later age compared to SCC and sarcoma groups (p<0.02) and had a shorter latency period compared to SCC and sarcoma groups (p<0.004) and melanoma (p<0.008). Local recurrence was present in 16% of the cases, while regional lymph node involvement was seen in 22% of the cases and distant metastases was present in 14% of the patients. The mortality rate was 21%. Although the main burn scar neoplasm was SCC, other neoplasms contributed to the morbidity and mortality of burn patients. Excision and grafting of deep burns, and close follow-up of non-healing ulcerated burn scars is essential for the prevention and early detection of burn scar neoplasms.

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Marjolin’s ulcer in chronic wounds – review of available literature

Dariusz Bazaliński, Joanna Przybek-Mita, Beata Barańska … (2017)

Marjolin’s ulcer is a rare, aggressive skin cancer developing in scar tissue, chronic ulcers and areas affected by inflammations. Its incidence is estimated to range from 1% to 2% of all burn scars. It most frequently takes the form of squamous cell carcinoma which sometimes is diagnosed during examination of lesions developing in scars and hard-to-heal chronic wounds (pressure sores, leg ulcers). Therapeutic management of Marjolin’s ulcer requires well-designed treatment plan to ensure optimal medical care and good quality of life for the patient. The high risk of metastases and damage to the structure of vitally important organs determines the need for early diagnosis and prompt surgical intervention with supplementary therapy. The purpose of the study was to examine etiopathogenesis of Marjolin’s ulcer and principles of its treatment. The authors focused on the aspect of malignant degeneration in chronic wounds (leg ulcers, pressure sores) as a very rare, aggressive form of Marjolin’s ulcer. A review of the available literature on the issue of Marjolin ulcers was conducted using the key words; Marjolin ulcers, pressure sore, chronic wound. Malignant degeneration in chronic wounds is a very rare aggressive form of Marjolin ulcer. Increased oncological alertness should be displayed by nursing and medical personnel taking care of patients with chronic wounds.

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Marjolin's ulcer: modern analysis of an ancient problem.

Brooks H Rohlen, W. Bradford Rockwell, Kian Samimi … (2008)

Marjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Although many individual case reports exist, no thorough evaluation of Marjolin's ulcer patients has been conducted to date. The authors present their experience with 10 patients encountered over a period of 15 years and analyze 25 previous publications, for a total of 443 patients diagnosed with Marjolin's ulcer. Although burn scar represents 76.5 percent of patients in the authors' review, venous stasis ulcers, traumatic wounds, osteomyelitis, and pressure sores are also represented as wound types that can undergo malignant degeneration. The authors' review suggests that there is much variability in the anatomical location of Marjolin's ulcers, with the majority occurring in wounds of the upper and lower extremities. Marjolin's ulcer appears to be preventable if early wound coverage is undertaken. Countries with limited access to medical treatment report a high number of Marjolin's ulcers compared with more developed regions.

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Author and article information

Journal

Journal ID (nlm-ta): J Bone Jt Infect

Journal ID (iso-abbrev): J Bone Jt Infect

Journal ID (publisher-id): jbji

Title: Journal of Bone and Joint Infection

Publisher: Ivyspring International Publisher (Sydney )

ISSN (Electronic): 2206-3552

Publication date Collection: 2019

Publication date (Electronic): 20 April 2019

Volume: 4

Issue: 3

Pages: 115-119

Affiliations

[1 ]Philadelphia College of Osteopathic Medicine Orthopaedic Surgery, Philadelphia, PA

[2 ]MedStar Georgetown Cancer Institute, National Center for Bone and Soft Tissue Tumors, MedStar Franklin Square Medical Center

[3 ]Rubin Institute for Advanced Orthopaedics, Baltimore, MD

Author notes

✉ Corresponding author: Mathew T. Wallace, 9103 Franklin Square Drive, Suite 2300, Baltimore, MD 21237. 443-777-2663; Matthew.T.Wallace@ 123456medstar.net

Competing Interests: The authors have declared that no competing interest exists.

Article

Publisher ID: jbjiv04p0115

DOI: 10.7150/jbji.34679

PMC ID: 6536801

SO-VID: 276e7de9-4c4c-4fd0-b0a5-a44c74bd7771

License:

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.

Marjolin's Tumor Complicating Chronic Periprosthetic Infection of a Total Knee Arthroplasty

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Abstract

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Decoding Infection and Transmission

Most cited references 15

Burn scar neoplasms: a literature review and statistical analysis.

Marjolin’s ulcer in chronic wounds – review of available literature

Marjolin's ulcer: modern analysis of an ancient problem.

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