Imaging of a Marjolin's Ulcer: A Case Report

Abstract

“Marjolin’s ulcer”refers to malignancies that developed in chronic venous ulcers, scars, or sinuses (1, 2). These malignancies also arise from various scars, including chronic ulcerations, inflammation, and fistulas after a long period of latency. Malignant transformation takes approximately 35 years. The incidence of malignant skin tumors that developed from scar tissue is 0.1-2.5%. Burn scars are the most common lesion causing this malignancy (3). The most common malignancy that arises from a Marjolin’s ulcer is squamous cell carcinoma, whereas basal cell carcinomas are rare. The malignancy is frequently multiple in the floor of an ulcer (3). The pathogenesis of a Marjolin’s ulcer is controversial (1, 3). Ulcer osteomas develop as a result of the heaping up of periosteum and associated subperiosteal sclerosis, and were seen as a knob-like mass protruding from the bone surface (1). These masses are rare in patients with chronic ulcers (1); however, they are frequently seen in patients with tropical ulcers, occurring in form of cutaneous leishmaniasis, which is a skin infection caused by a single-celled parasite that is transmitted by sandfly bites (4). A previous report described gadopentetate dimeglumine-enhanced magnetic resonance imaging (MRI) as a useful tool for evaluating a Marjolin’s ulcer (2). A multidisciplinary approach using three-dimensional computed tomography (CT) and positron emission tomography J Korean Soc Radiol 2011;64:593-598