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A 33-year-old man who had sustained a burn injury to his left upper arm as a child presented with a rapidly growing, fungating ulcer in the burn scar. A biopsy of the mass revealed invasive squamous-cell carcinoma consistent with Marjolin's ulcer. The patient underwent wide local excision and placement of a split-thickness skin graft. No evidence of tumor was identified in the sentinel lymph nodes. Dr. Jean Nicolas Marjolin first described the occurrence of ulcerating lesions within scar tissue in 1828. Marjolin's ulcer is the term given to these aggressive epidermoid tumors that arise from areas of chronic injury, with burn wounds being a common site.
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