Carcinoma squamo-cellulare di Marjolin

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Carcinoma squamo-cellulare di Marjolin
Marjolin ulcer.JPG
Codici di classificazione
ICD-10 (EN) C44.8

Il carcinoma squamo-cellulare di Marjolin o ulcera di Marjolin è un tumore maligno della cute che può insorgere raramente in aree cutanee già colpite da ulcere,[1][2] o da gravi ustioni.[3][4] In letteratura i dati relativi alla sua frequenza sono bassi, 2-5 casi su mille.

Cenni storici[modifica | modifica sorgente]

Il primo riscontro in letteratura risale al 1903 in un lavoro di Da Costa che indicò come ulcera di Marjolin una ulcera venosa degenerata.[5]

Eziologia[modifica | modifica sorgente]

Il processo per cui si viene ad instaurare questa forma di tumore maligno è poco chiara, si è a conoscenza che il tumore si sviluppa in aree di cute in cui vi è una cronicità della lesione. Il periodo di latenza, ossia da quando inizia l’evento traumatico e il manifestarsi del tumore, è abbastanza lungo (alcuni autori parlano di 20-32 anni) ed è inversamente proporzionale all’età; questo incide sulla formulazione di una diagnosi tempestiva.

Diagnosi[modifica | modifica sorgente]

La biopsia è il metodo favorito di diagnosi. Campioni di tessuto dovrebbero essere estratti dal centro e il margine della lesione, così come dalle zone ulcerate e zone necrotiche.

Trattamento[modifica | modifica sorgente]

Si predilige il trattamento chirurgico; si rimuove la lesione completamente e circa un centimetro di bordo sano attorno all’ulcerazione. La radio-terapia è un’alternativa di trattamento non invasivo che ha dato soddisfacenti esiti in molti casi.

Prognosi[modifica | modifica sorgente]

Il tumore data la sua aggressività ha un alto grado di mortalità:[6] 4 casi su 5.

Note[modifica | modifica sorgente]

  1. ^ Esther RJ, Lamps L, Schwartz HS, Marjolin ulcers: secondary carcinomas in chronic wounds in J South Orthop Assoc, vol. 8, nº 3, 1999, pp. 181–7, PMID 12132863.
  2. ^ Simmons MA, Edwards JM, Nigam A, Marjolin's ulcer presenting in the neck in J Laryngol Otol, vol. 114, nº 12, dicembre 2000, pp. 980–2, PMID 11177375.
  3. ^ Freedberg, et. al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  4. ^ Phillips TJ, Salman SM, Bhawan J, Rogers GS, Burn scar carcinoma. Diagnosis and management in Dermatol Surg, vol. 24, nº 5, maggio 1998, pp. 561–5, DOI:10.1016/S1076-0512(98)00022-3, PMID 9598012.
  5. ^ Riforma medica: giornale internazionale settimanale de medicina, chirurgia e scienze affini, 1985.
  6. ^ AJ. Chong, MB. Klein, Images in clinical medicine. Marjolin's ulcer. in N Engl J Med, vol. 352, nº 10, marzo 2005, pp. e9, DOI:10.1056/NEJMicm040020, PMID 15758002.

Bibliografia[modifica | modifica sorgente]

  • Sukhpal Sawhney, Rajeev Jain, Anupam Kakaria, and Pradeep Chopra; Marjolin’s Ulcer: Radiographic and magnetic resonance appearances in two cases. Sultan Qaboos Univ Med J. 2009 August; 9(2): 162–166. Published online 2009 June 30. PMCID: PMC3074775.
  • Urszula Ochenduszkiewicz,Rafał Matkowski Bartłomiej Szynglarewicz,Jan Kornafel "Marjolin’s ulcer: malignant neoplasm arising in scars" Reports of Practical Oncology and Radiotherapy; Volume 11, Number 3, 2006.
  • M.Monti; L'ulcera cutanea: approccio multidisciplinare alla diagnosi ed al trattamento; Milano 2000. ISBN 88-470-0072-6.
  • Mazzeo Francesco; Trattato di clinica e terapia chirurgica; Padova, 2001- ISBN 88-299-1566-1.
  • Esther RJ, Lamps L, Schwartz HS (1999). "Marjolin ulcers: secondary carcinomas in chronic wounds". J South Orthop Assoc 8 (3): 181–7.
  • Simmons MA, Edwards JM, Nigam A (December 2000). "Marjolin's ulcer presenting in the neck". J Laryngol Otol 114 (12): 980–2.
  • Fishman J.R.A., Parker M.G.; Malignancy and chronic wounds: Marjolin's Ulcer. J. Bum Care and Rehab., 12, 3: 1991.
  • Freedberg, et. al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  • HILL, BRAD B. MD; SLOAN, DAVID A. MD; LEE, EUN Y. MD; McGRATH, PATRICK C. MD; KENADY, DANIEL E. MD Marjolin's Ulcer of the Foot Caused by Nonburn Trauma in Southern Medical Journal September/October 1990 - Volume 11 - Issue 5.
  • Phillips TJ, Salman SM, Bhawan J, Rogers GS (May 1998). "Burn scar carcinoma. Diagnosis and management". Dermatol Surg 24 (5): 561–5.
  • Smidt LS, Smidt LF, Chedid MB, Bavaresco CS, Chedid MF (October 2005). "Radical surgical treatment for Marjolin ulcer occurring after chronic osteomyelitis". South. Med. J. 98 (10): 1053. Wolters Kluwer Health - Article Landing Page
  • Chong AJ, Klein MB (March 2005). "Images in clinical medicine. Marjolin's ulcer". N. Engl. J. Med. 352 (10): e9. doi:10.1056/NEJMicm040020.
  • Paredes F (February 1998). "[Marjölin ulcer]" (in Portoghese). Acta Med Port 11 (2): 185–7.
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  • Trent, Jennifer T. MD; Kirsner, Robert S. MD: Wounds and Malignancy in Advances in Skin & Wound Care: January/February 2003 - Volume 16 - Issue 1 - pp 31-34.
  • Agale SV, Kulkarni DR, Valand AG, Zode RR, Grover S.: Marjolin's ulcer--a diagnostic dilemma. J Assoc Physicians India. 2009 Aug;57:593-4. Department of Pathology, Grant Medical College, Mumbai-400 008. *Baskara A, Sikka L, Khan F, Sapanara N.: Development of a Marjolin's ulcer within 9 months in a plantar pressure ulcer. Eur J Dermatol. 2010 Feb 23.
  • Carlesimo B, Monarca C, Rizzo MI, Tariciotti F, Staccioli S.: Hemipelvectomy and reconstruction in a patient with advanced Marjolin's ulcer: a case report. Int J Low Extrem Wounds. 2009 Sep;8(3):162-4. Department of Plastic and Reconstructive Surgery, La Sapienza University of Rome, Italy.
  • Daya M, Balakrishan T.: Advanced Marjolin's ulcer of the scalp in a 13-year-old boy treated by excision and free tissue transfer: Case report and review of literature. Indian J Plast Surg. 2009 Jan-Jun;42(1):106-11. Department of Plastic and Reconstructive Surgery, Nelson R Mandela School of Medicine, University of Kwazulu-Natal, Durban, South Africa.
  • Bula P, Bula-Sternberg J, Wollina U, Haroske G, Bonnaire F.: [Marjolin's ulcer: malignant transformation of a crural ulcer due to posttraumatic chronic osteomyelitis].[D] Unfallchirurg. 2010 Feb;113(2):149-54. Klinik für Unfall-, Wiederherstellungs- und Handchirurgie, Städtisches Klinikum Dresden-Friedrichstadt, 01067, Dresden, Deutschland. bula-ph@khdf.de
  • Pandey M, Kumar P, Khanna AK. Marjolin's ulcer associated with chronic osteomyelitis. J Wound Care. 2009 Dec;18(12):504-6. Department of General Surgery, Institute of Medical Science, Banaras Hindu University, Varanasi, India. akhannabhu@gmail.com.
  • Sengul G, Hadi-Kadioglu H. Penetrating Marjolin's ulcer of scalp involving bone, dura mater and brain caused by blunt trauma to the burned area. Neurocirugia (Astur). 2009 Oct;20(5):474-7; discussion 477. Department of Neurosurgery. Medical School. Ataturk University. Erzurum. Turkey.
  • Sharma RK.: Is Marjolin's ulcer always a squamous cell carcinoma? last Reconstr Surg. 2009 Sep;124(3):1005; author reply 1005-6. Shedding some light on the old problem.
  • Copcu E.: Marjolin's ulcer: a preventable complication of burns? Plast Reconstr Surg. 2009 Jul;124(1):156e-64e. Plastic, Reconstructive, and Aesthetic Surgery Department, Medical Faculty, Adnan Menderes University, Aydin, Turkey. ecopcu@adu.edu.tr.
  • Shahla A.: An overview of heel Marjolin's ulcers in the Orthopedic Department of Urmia University of Medical Sciences.Arch Iran Med. 2009 Jul;12(4):405-8. Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran. a_shahla@umsu.ac.ir
  • Onah II, Okwor B, Onuigbo WI.: Penetrating scalp Marjolin's ulcer involving bone and dura mater in a Nigerian hospital: Case report and literature review. Burns. 2009 Jun 5. [Epub ahead of print] Department of Plastic Surgery, National Orthopaedic Hospital, Enugu, Nigeria.
  • Asuquo ME, Udosen AM, Ikpeme IA, Ngim NE, Otei OO, Ebughe G, Bassey EE.: Cutaneous squamous cell carcinoma in Calabar, southern Nigeria.Clin Exp Dermatol. 2009 Dec;34(8):870-3. Epub 2009 May 18. Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria. mauefas@yahoo.com
  • Chandramohan K, Mathews A, Kurian A, Thomas S, Ramachandran K.: Squamous cell carcinoma arising from perineal lesion in a familial case of Hidradenitis suppurativa. Int Wound J. 2009 Apr;6(2):141-4. Department of Surgical Oncology, Regional Cancer Centre, Kerala, India. drchandramohan@gmail.com
  • Snyder RJ.: Skin cancers and wounds in the geriatric population: a review.Ostomy Wound Manage. 2009 Apr;55(4):64-76. Wound Healing Center at University Hospital, Tamarac, Florida, USA. drwound@aol.com.
  • Hall AB, Buehler KE, Philipneri M.: Hypercalcemia complicating Marjolin's ulcer. Mil Med. 2009 Mar;174(3):308-10. Department of Internal Medicine, St. Louis University School of Medicine, 3635 Vista Avenue, 9th floor, St. Louis, MO 63110, USA.
  • Schnell LG, Danks RR.: Massive Marjolin's ulcer in a burn graft site 46 years later. J Burn Care Res. 2009 May-Jun;30(3):533-5.
  • Battaglia M, Treadwell T.: Marjolin's ulcer. Ala Nurse. 2008 Dec-2009 Feb;35(4):4. Review.
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  • Prayaga AK, Loya AC, Gottimukkala SR, Digumarti RR, Maddali LS, Challa S. Cytologic features of primary malignant tumors of skin and adnexae. Acta Cytol. 2008 Nov-Dec;52(6):702-9.PMID: 19068675.
  • Bloemsma GC, Lapid O.: Marjolin's ulcer in an amputation stump. J Burn Care Res. 2008 Nov-Dec;29(6):1001-3.
  • Gatto A, Sebastiani S, Falvo L, Giustiniani C, La Rovere C.: A rare case of aggressive squamous-cell carcinoma of the breast skin: Marjolin's ulcer. A case report. Chir Ital. 2008 Jul-Aug;60(4):577-82.
  • Ogawa B, Chen M, Margolis J, Schiller FJ, Schnall SB. Marjolin's ulcer arising at the elbow: a case report and literature review. Hand (N Y). 2006 Dec;1(2):89-93.
  • Soto-Dávalos BA, Cortés-Flores AO, Bandera-Delgado A, Luna-Ortiz K, Padilla-Rosciano AE. [Malignant neoplasm in burn scar: Marjolin's ulcer. Report of two cases and review of the literature]. Cir Cir. 2008 Jul-Aug;76(4):329-31. Review. Spanish.
  • Chiang KH, Chout AS, Chang PY.: Reply to Buckley O, Munk PL, Torreggiani WC. MRI of Marjolin's ulcer. AJR 2007; 189:W171. AJR Am J Roentgenol. 2008 Sep;191(3):W151.
  • Toporcer T, Lakyová L, Babjaková L, Zábavníková M, Belák J, Radonak J.: [Chronic wound as a precancerosis (Ulcus marjolini--Marjolin's ulcer)--a case review] Rozhl Chir. 2008 Jun;87(6):317-21. Slovak.
  • Emsen IM.: A great Marjolin's ulcer of the scalp invading outer calvarial bone and its different treatment with support of Medpor. J Craniofac Surg. 2008 Jul;19(4):1026-9.
  • Mesgarzadeh AH, Farahani RM, Treister N.: Malignant fibrous histiocytoma of the mandible in the context of a traumatic Marjolin's ulcer. J Tissue Viability. 2008 May;17(2):38-43. Review.
  • Rieger UM, Kalbermatten DF, Wettstein R, Heider I, Haug M, Pierer G.: Marjolin's ulcer revisited--basal cell carcinoma arising from grenade fragments? Case report and review of the literature. J Plast Reconstr Aesthet Surg. 2008;61(1):65-70. Epub 2006 Sep 1. Review.
  • Asuquo M, Ugare G, Ebughe G, Jibril P.: Marjolin's ulcer: the importance of surgical management of chronic cutaneous ulcers. Asuquo M, Ugare G, Ebughe G, Jibril P. Int J Dermatol. 2007 Oct;46 Suppl 2:29-32.
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  • Kim NG, Lee KS, Choi TH, Kim JS, Choi JH, Jang PY, Han KH, Son DG, Kim JH.: Aesthetic reconstruction of lower leg defects using a new anterolateral lower leg perforator flap. J Plast Reconstr Aesthet Surg. 2008 Aug;61(8):934-8. Epub 2007 Aug 2.
  • Knudsen MA, Biering-Sørensen F.: Development of Marjolin's ulcer following successful surgical treatment of chronic sacral pressure sore. Knudsen MA, Biering-Sørensen F. Spinal Cord. 2008 Mar;46(3):239-40. Epub 2007 Jul 3.
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  • Bauer T, David T, Rimareix F, Lortat-Jacob A. [Marjolin's ulcer in chronic osteomyelitis: seven cases and a review of the literature] Rev Chir Orthop Reparatrice Appar Mot. 2007 Feb;93(1):63-71. Review. (F).
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  • Tan BC, Horton TC, Sara Ahmad T.: Marjolin's ulcer--a near forgotten entity. Med J Malaysia. 2006 Feb;61 Suppl A:91-3.
  • Yuste García P, Villarejo Campos P, Menéndez Rubio JM, García Garciá A, Pérez Viejo E, Gambí Pisonero D, Martinez Pueyo JI, Cruz Vigo F.: Marjolin's ulcer arising from a laparostomy scar. Int Surg. 2006 Jul-Aug;91(4):207-10.
  • Momeni A, Stark GB.: Early Marjolin's ulcer in Bureau-Barriere syndrome. Int J Low Extrem Wounds. 2006 Sep;5(3):204-6.
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  • Enoch S, Miller DR, Price PE, Harding KG.: Early diagnosis is vital in the management of squamous cell carcinomas associated with chronic non healing ulcers: a case series and review of the literature. Int Wound J. 2004 Sep;1(3):165-75. Review.
  • Rodríguez Anguiano Jorge Iván, Alba Laguna Eva Miriam, Mauro Ibarra Juana Yadira, Romo Sánchez Manuel Gabriel, Muñóz Camacho José Guadalupe, Molina Cárdenas Hugo Roberto. Úlcera de Marjolin. Presentación de un caso y revisión de la literatura Med Int Mex 2002; 18(2): 106-109.
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