A Clinical Study of Incidence of Lymph Node Metastasis of Marjolin’s Ulcer
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 5, Pages 546-554
AbstractBackground: Marjolin's ulcer is a rare and frequently severe skin cancer that develops in chronically inflamed or injured skin, especially following burns. Marjolin's ulcers can also form from previously traumatized and scarred tissue and are present in 1% to 2% of all burn scars. The present study attempted to determine the incidence and lymph node metastasis in cases of Marjolin’s ulcers reported to the Regional Cancer Center.
Methods: The study of these n=43 Marjolin’s ulcer cases was carried out. After obtaining ethical clearance from the institution this study was carried out. The data is collected from patients who have undergone treatment in the form of surgery or palliative chemotherapy or conservative management. All the n=43 patients were subjected to investigations as required according to the patient. Regional lymph nodes are assessed by both clinical palpation and ultrasound of the regional lymph nodal area.
Results: In this study of n=43 cases of Marjolin’s Ulcer, n=18 patients (40%) did not have clinically palpable lymph nodes whereas n=25 patients (60%) have clinically detectable regional lymph nodes. These lymph nodes were divided into clinically significant nodes (Lymph nodes > 2cms) and clinically Non-significant Lymph nodes (Lymph nodes <2cms). In this prospective study, of n=25 patients with clinically detectable lymph nodes, n=7 (16%) patients had clinically significant lymph nodes and n=18 (41%) patients did not have clinically significant palpable lymph nodes.
Conclusion: The most common etiological factor for Marjolin’s ulcers was Burns. Males are more commonly affected than females. Squamous cell carcinoma is the most common variant of Marjolin’s ulcer. Most of Marjolin’s Ulcers are Well-differentiated cancers (90%) of cases. The incidence of lymph node metastasis in this study was 22%. Among all the factors for metastasis lymph node size is a significantly important predictor of metastasis.
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