Slow growth, painlessness (as the ulcer is usually not associated withnerve tissue), and absence oflymphatic spread due to local destruction of lymphatic channels.[8]
Museum specimen of Marjolin's' ulcer on the sole of a foot
Histologically, the tumour is a well-differentiatedsquamous cell carcinoma. This carcinoma is aggressive in nature, spreads locally and is associated with a poorprognosis.[7] The cancer has a 18-38% rate ofmetastasis.[9]40% occur on the lower limb and the malignant change is usually painless. This malignant change of the wound happens a long time after initial trauma, usually 10–25 years later. Its edge is everted and not always raised. More recent transcriptional analysis suggests that chronically impededextracellular matrix turnover andepithelium-to-mesenchyme transitions in neglected scar tissue might give rise to this malignancy.[10][11]
Wedge biopsy is the favored method of diagnosis.Tissue specimens obtained should be taken from both the centre and margin oflesion, as the central ulcerated deposits may benecrotic.
^abChong AJ, Klein MB (March 2005). "Images in clinical medicine. Marjolin's ulcer".N. Engl. J. Med.352 (10): e9.doi:10.1056/NEJMicm040020.PMID15758002.
^Paredes F (February 1998). "[Marjölin ulcer]".Acta Med Port (in Portuguese).11 (2):185–7.PMID9567417.
^Motley, T., White, K. and Clyde, J. (2014). Squamous cell carcinoma of the foot: A case report. The Foot and Ankle Online Journal, 7(2): 2.[1]
^Sinha S, Su S, Workentine M, Agabalyan N, Cheng M, Gabriel V, Biernaskie J (January 2017). "Transcriptional Analysis Reveals Evidence of Chronically Impeded ECM Turnover and Epithelium-to-Mesenchyme Transition in Scar Tissue Giving Rise to Marjolin's Ulcer".J Burn Care Res.38 (1):e14–e22.doi:10.1097/BCR.0000000000000432.PMID27679957.S2CID3702018.
^Sinha S, Arora R, Kutluberk E, Verly M, Small C, Herik A, Burnett L, Cao L, Thoppey Manoharan V, Chockalingam K, van der Vyver M, Ponjevic D, Sparks HD, Morrissy S, Harrop AR, Brenn T, Nikolic A, Temple-Oberle C, Rosin N, Gabriel V, Biernaskie J (August 2024). "Spatial and Single-Cell Transcriptomics Reveal that Oncofetal Reprogramming of Fibroblasts Is Associated with Malignant Degeneration of Burn Scar".J Invest Dermatol.doi:10.1016/j.jid.2024.07.022.PMID39128494.
