Abdolazim Ghalambor.
Marjolin ulcer: How much of safety margin needs resection along marjolin ulcer squamous cell carcinoma in recurrence cases.
Pak J Med Sci Jan ;23(3):394-7.

Objective: The main aim of this study was to evaluate how much of the surrounding area need to be resected to reach tumor free margin in cases of recurrent Squamous Cell Carcinoma (SCC) Marjolin ulcer. The other objective was to report the demographic characteristics, the site of development of SCC Marjolin ulcers. Methodology: A total of 266 patients with ulcers created on burn scars were studied. Biopsy samples were taken from all ulcers and evaluated pathologically for chronic inflammation or SCC Marjolin ulcer. For primary SCC Marjolin ulcers a 2cm safety margin was removed, while for recurrent SCC Marjolin ulcers a 2cm safety margin was removed and assessed pathologically under frozen-section and a further 0.5cm safety margin was removed in cases of SCC involvement in any of the planes of the resected sections for reaching a SCC-clear margin. Results: One hundred eighteen of the cases were due to chronic inflammation, and the remaining 148 cases were due to SCC Marjolin ulcers. Of this 31 cases were recurrent ones. At least one site of all the recurrent SCC Marjolin ulcer samples were found to be involved and required a second resection attempt for reaching a clear and a safe margin. Conclusion: Although classically 2cm safety margin is still widely used for resection of primary SCC Marjolin ulcers, we recommend that a 2.5cm safety margin is better for resection in recurrent cases.

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