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Parintosa Atmowirdjo Sachraswaty Laidding

Abstract

Marjolin’s ulcers are a rare squamour cell carcinomas which develops in non-healing scar tissue. The most frequent predisposing lesion is in a post burn wound, especially after flame burns. Incidence appears to be on the rise and outcome of treatment remains poor. A 51-years old male with burn scar at the posterior left calf since 43 years ago. After burnt, the wound was left to heal spontaneously with minimal treatment. Three years later an unhealing wound emerged on the scar. This wound got bigger, spreaded further, turned into a mass 15 x 8 x 5 cm in size. The tumor was mobile, ulcerative with unprovoked bleeding, malodorous, and painful. Biopsy and imaging concluded a diagnosis of Squamous Cell Carcinoma from Marjolin’s Ulcer, Stage III (T4N0M0). Wide excision was performed 1-2 cm from hiperemis area, neighboring muscles sacri"ced. Frozen section revealed a free-tumor margin and wound covered by split thicknes skin graft. On folllow up, STSG’s “take” was 100%. Four months postoperation, a wound the size of 1 x 1 x 0,5 cm appeared at the distal left posterior calf. Biopsy was performed, result showed granulating tissues with no sign of malignancy. The wound was treated in the outpatient, and healed well. Marjolin Ulcer’s prognosis is not very favorable so it best to prevent at the best first place.

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Section
WOUND HEALING / EXPERIMENTAL