New onset squamous cell carcinoma in previous split-thickness skin graft donor site

Int J Surg. 2018 Apr:52:16-19. doi: 10.1016/j.ijsu.2018.01.047. Epub 2018 Feb 10.

Abstract

Introduction: Marjolin' s ulcer, an aggressive ulcerating squamous cell carcinoma, is a well-known phenomenon that occurs in chronically inflamed or scarred tissue; however, squamous cell carcinoma arising in the acute setting after tissue trauma - specifically autograft donor harvest sites for burns - is a rare, but notable event.

Methods: This case series describes three instances of squamous cell carcinoma diagnosed in split-thickness skin graft donor sites in the immediate post-operative period. Charts were reviewed in detail after at least 9 months follow-up from identification of the tumor. Detailed descriptions of each case are included. A discussion of the literature on this rare entity is included as well.

Results: In the three cases discussed, all were characterized clinically as painful masses arising in a recently healed donor site. Two were managed surgically with adherence to oncologic principals. One lesion regressed or fell off spontaneously. With at least 9 months follow-up, there was no evidence of recurrence.

Conclusions: Very few cases of acute neoplasm in donor sites have been described in the literature. Presently, there is no dominant theory as to how these lesions arise; however, this is an entity that burn care providers, world wide should be aware of, with a low threshold for oncologic evaluation if suspected.

Keywords: Donor site; Marjolin's ulcer; Split thickness autograft; Squamous cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Burns / surgery
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery
  • Postoperative Complications / pathology
  • Skin / pathology
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery
  • Skin Transplantation / adverse effects*
  • Transplantation, Autologous / adverse effects