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Category: Volume 08 Issue 04 April 2020
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Title: Early Detection of Malignancy using Cytokeratin, HMB45 and Vimentin in OPD Patients with Marjolin’s Ulcer

Authors: Dr Saurabh Gupta, Dr Aarti B. Bhattacharya, Dr Rashmi Chaturvedi, Dr Sanjiv Bhatia

 DOI: https://dx.doi.org/10.18535/jmscr/v8i4.04

Abstract

   

Objective: To study clinico-pathological features of Marjolin’s ulcer patients attending surgical clinics and to classify Marjolin’s ulcer using Cytokeratin, Vimentin and HMB45 expression.

Methods: A cross-sectional clinical correlation study was done on 39 patients who presented to surgical OPD with clinical diagnosis of Marjolin's ulcer arising from chronic skin conditions. Histopathological evaluation and Immunohistochemistry was performed in all cases. Statistics Chi square test and statistical package for social science software (SPSS) version 23. P value <0.05 was taken as statistically significant.

Results: Of the total 39 cases majority of the cases were in the age group of 41-50 years (30.76%) with mean age of 47.53 years. M:F ratio was 2:1. Burn was the most common lesion (66.67%) followed by trauma (30.80%) and surgical scar (2.60%). Foot was the most common site of lesion (28.20%) followed by leg (25.64%). Mean time interval taken was 13.12 years. Shortest time interval was 6 years, whereas longest time taken was 25 years. Well differentiated Squamous cell carcinoma was the most common histology type (79.48%) followed by moderately differentiated Squamous cell Carcinoma. One case of sarcomatoid carcinoma is also present (02.56%). 25.64% of cases had lymph node metastasis. Majority of the cases were positive for cytokeratin stain (97.43%) followed by one case positive for both Cytokeratin and Vimentin (2.56%).

Conclusion: Burn scar transformation into malignancy was more prominent than other causes. The grade of the tumor and presence of metastasis greatly influence the prognosis of the patient. By application of immunohistochemical stains, we were able to delineate the origin of the malignancy, being epithelial, mesenchymal or melanotic.

Keywords: Marjolin’s ulcer, Chronic Skin Conditions, Grade, Lymph Node Metastasis.

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Corresponding Author

Dr Saurabh Gupta

Resident, Department of Pathology, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India