Surgical treatment of scar carcinoma - methods and results

Introduction: The prognosis of scar carcinoma, also known as Marjolin's ulc er, is poor. Metastases of lymph nodes often appear because of late diagnos is and the underestimation of clinical findings. This has a deep impact on the quality of life of the patients. Scar carcinoma often occurs in burn sc ars, but also in chronic ulcers of the lower extremities and in chronic pre ssure sores. Methods: Between 1994 and 1998 12 patients with scar carcinoma were treated at our hospital. In all cases radical surgery of the entire s car area was undertaken, followed by dissection of the draining lymph nodes . Free flaps, pendicular flaps or splint skin grafts were used to cover the resulting defects. Results: In 16.6% we observed positive lymph nodes. The re were two cases of local recurrence. Five patients died during the observ ation time. In one patient the extremity had to be amputated. Conclusion: E arly diagnosis and radical excision are requirements, and the quality of li fe can be improved with plastic surgery. Aftercare and yearly staging measu res are mandatory.