[Surgical treatment of cicatricial carcinoma--methods and results]

INTRODUCTION: The prognosis of scar carcinoma, also known as Marjolin's ulcer, is poor. Metastases of lymph nodes often appear because of late diagnosis 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 scars, but also in chronic ulcers of the lower extremities and in chronic pressure sores. METHODS: Between 1994 and 1998 12 patients with scar carcinoma were treated at our hospital. In all cases radical surgery of the entire scar 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. There were two cases of local recurrence. Five patients died during the observation time. In one patient the extremity had to be amputated. CONCLUSION: Early diagnosis and radical excision are requirements, and the quality of life can be improved with plastic surgery. Aftercare and yearly staging measures are mandatory.