Slow growth, painlessness (as the ulcer is usually not associated with nerve tissue), and absence of lymphatic 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 poor prognosis.[7] The cancer has a 18-38% rate of metastasis.[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 impeded extracellular matrix turnover and epithelium-to-mesenchyme transitions in neglected scar tissue might give rise to this malignancy.[10]
Wedge biopsy is the favored method of diagnosis. Tissue specimens obtained should be taken from both the centre and margin of lesion, as the central ulcerated deposits may be necrotic.
^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. doi:10.1097/01.smj.0000182509.78816.7b. PMID16295826.
^ 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.