Sentinel Lymph Node Biopsy Identifies Occult Nodal Metastases in Patients with Marjolin's Ulcer

Alexander Eastman, W. A. Erdman, G. M. Lindberg, J. L. Hunt, G. F. Purdue, Jason B. Fleming

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Since Marjolin's description, the management of burn scar carcinoma has remained controversial. A multitude of options and recommendations exist for the management of both primary lesions and regional nodal metastasis. This work reviews six cases of Marjolin's ulcer staged using sentinel lymph node biopsy. All primary lesions were confirmed to be squamous cell carcinoma and occurred a median of 29.5 years after burn. No patient had clinically detectable lymphadenopathy. In all cases, preoperative lymphoscintigraphy successfully identified a single draining regional nodal basin. Subsequent intraoperative lymphatic mapping/sentinel lymph node (SLN) biopsy was successful in five of six cases (83%). A successful intraoperative lymphatic mapping/SLN biopsy was defined as the identification of blue (uptake of isosulfan blue dye) or "hot" (uptake of radiolabeled sulfur colloid as measured with a handheld gamma counter) node(s) and subsequent excision. Four of five SLN biopsies identified previously occult nodal metastasis. SLN biopsy represents a minimally invasive and accurate staging procedure for Marjolin's ulcer.

Original languageEnglish (US)
Pages (from-to)241-245
Number of pages5
JournalJournal of Burn Care and Rehabilitation
Volume25
Issue number3
DOIs
StatePublished - Jan 1 2004

ASJC Scopus subject areas

  • Surgery
  • Nursing(all)
  • Emergency Medicine
  • Rehabilitation
  • Health Professions(all)

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