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Malignant melanoma arising in a burn scar

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Abstract

Secondary malignancies are rare but devastating complications of longstanding burn scars. Squamous cell carcinoma is the most common, followed by basal cell carcinoma and melanomas. There are fewer than 50 total reported cases of malignant melanomas arising in burn scars. We report a case of malignant melanoma arising within a longstanding burn scar confirmed by histology, FISH, and PRAME staining to further characterize melanomas arising in burn scars and to illustrate the diagnostic challenges they present.

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No datasets were generated or analysed during the current study.

Abbreviations

BCC:

Basal cell carcinoma

SCC:

Squamous cell carcinoma

PRAME:

Preferentially expressed antigen in melanoma

FISH:

Fluorescence in situ hybridization

References

  1. Gnaneshwar Rao A, Jhamnani KK, Konda C (2008) Nodular melanoma in a skin graft site scar. Indian J Dermatology Venereol Leprology 74:159–161

    Article  Google Scholar 

  2. Treves N, Pack GT (1930) The development of cancer in burn scars: an analysis and report of thirty-four cases. Surg Gynecol Obstet 51:749–782

    Google Scholar 

  3. Lee HB, Han SE, Chang LS, Lee SH (2019) Malignant melanoma on a thermal burn scar. Arch Craniofac Surg 20:58–61. https://doi.org/10.7181/acfs.2018.02103

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kowal-Vern A, Criswell BK (2005) Burn scar neoplasms: a literature review and statistical analysis. Burns 31:403–413. https://doi.org/10.1016/j.burns.2005.02.015

    Article  PubMed  Google Scholar 

  5. Kerr-Valentic MA, Samimi K, Rohlen BH, Agarwal JP, Rockwell WB (2009) Marjolin’s ulcer: modern analysis of an ancient problem. Plast Reconstr Surg 123:184–191. https://doi.org/10.1097/PRS.0b013e3181904d86

    Article  CAS  PubMed  Google Scholar 

  6. Akay BN, Atak MF, Heper AO, Farabi B (2019) Spindle cell melanoma arising in a burn scar: an unusual presentation with dermatoscopic findings. Dermatol Ther 32:e13123. https://doi.org/10.1111/dth.13123

    Article  PubMed  Google Scholar 

  7. Bostwick J, Pendergrast WJ, Vasconez LO (1976) Marjolin’s ulcer: an immunologically privileged tumor? Plast Reconstr Surg 57:66–69

    Article  PubMed  Google Scholar 

  8. Kikuchi H, Nishida T, Kurokawa M, Setoyama M, Kisanuki A (2003) Three cases of malignant melanoma arising on burn scars. J Dermatol 30:617–624. https://doi.org/10.1111/j.1346-8138.2003.tb00445.x

    Article  PubMed  Google Scholar 

  9. Saaiq M, Ashraf B (2014) Marjolin’s ulcers in the post-burned lesions and scars. World J Clin Cases 2:507–514. https://doi.org/10.12998/wjcc.v2.i10.507

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sinha S, Su S, Workentine M, Agabalyan N, Cheng M, Gabriel V, Biernaskie J (2017) Transcriptional analysis reveals evidence of chronically impeded ECM turnover and epithelium-to-mesenchyme transition in scar tissue giving rise to Marjolin’s Ulcer. J Burn Care Res 38:e14–22. https://doi.org/10.1097/BCR.0000000000000432

    Article  PubMed  Google Scholar 

  11. Harland DL, Robinson WA, Franklin WA (1997) Deletion of the p53 gene in a patient with aggressive burn scar carcinoma. J Trauma 42:104–107. https://doi.org/10.1097/00005373-199701000-00018

    Article  CAS  PubMed  Google Scholar 

  12. Ghorbani Z, Dowlati Y, Mehregan AH (1996) Amelanotic Spitzoid Melanoma in the burn scar of a child. Pediatr Dermatol 13:285–287. https://doi.org/10.1111/j.1525-1470.1996.tb01240.x

    Article  CAS  PubMed  Google Scholar 

  13. Iqbal FM, Sinha Y, Jaffe W (2015) Marjolin’s ulcer: a rare entity with a call for early diagnosis. BMJ Case Rep. 2015:bcr2014208176. https://doi.org/10.1136/bcr-2014-208176

  14. Trent JT, Kirsner RS (2003) Wounds and malignancy. Adv Skin Wound Care 16:31–34. https://doi.org/10.1097/00129334-200301000-00014

    Article  PubMed  Google Scholar 

  15. Chalya PL, Mabula JB, Rambau P et al (2012) Marjolin’s ulcers at a university teaching hospital in Northwestern Tanzania: a retrospective review of 56 cases. World J Surg Oncol 10:38. https://doi.org/10.1186/1477-7819-10-38

    Article  PubMed  PubMed Central  Google Scholar 

  16. Yeon SY, Jung SH, Kim MS, Chung Y-J, Lee SH (2018) Targeted sequencing of burn scar-related squamous cell carcinomas identified PIK3CA amplification. Pathology 50:568–571. https://doi.org/10.1016/j.pathol.2018.02.001

    Article  PubMed  Google Scholar 

  17. Ferrara G, De Vanna AC (2016) Fluorescence in situ hybridization for Melanoma diagnosis: a review and a reappraisal. Am J Dermatopathol 38:253–269. https://doi.org/10.1097/DAD.0000000000000380

    Article  PubMed  Google Scholar 

  18. Gerami P, Jewell SS, Morrison LE et al (2009) Fluorescence in situ hybridization (FISH) as an ancillary diagnostic tool in the diagnosis of melanoma. Am J Surg Pathol 33:1146–1156. https://doi.org/10.1097/PAS.0b013e3181a1ef36

    Article  PubMed  Google Scholar 

  19. Song J, Mooi WJ, Petronic-Rosic V, Shea CR, Stricker T, Krausz T (2011) Nevus versus melanoma: to FISH, or not to FISH. Adv Anat Pathol 18:229–234. https://doi.org/10.1097/PAP.0b013e3182169b69

    Article  CAS  PubMed  Google Scholar 

  20. Gerami P, Mafee M, Lurtsbarapa T, Guitart J, Haghighat Z, Newman M (2010) Sensitivity of fluorescence in situ hybridization for Melanoma diagnosis using RREB1, MYB, Cep6, and 11q13 probes in Melanoma subtypes. Arch Dermatol 146:273–278. https://doi.org/10.1001/archdermatol.2009.386

    Article  PubMed  Google Scholar 

  21. Toussi A, Mans N, Welborn J, Kiuru M (2020) Germline mutations predisposing to melanoma. J Cutan Pathol 47:606–616. https://doi.org/10.1111/cup.13689

    Article  PubMed  PubMed Central  Google Scholar 

  22. Read J, Wadt KAW, Hayward NK (2016) Melanoma genetics. J Med Genet 53:1–14. https://doi.org/10.1136/jmedgenet-2015-103150

    Article  CAS  PubMed  Google Scholar 

  23. Lezcano C, Jungbluth AA, Nehal KS, Hollmann TJ, Busam KJ (2018) PRAME expression in Melanocytic Tumors. Am J Surg Pathol 42:1456–1465. https://doi.org/10.1097/PAS.0000000000001134

    Article  PubMed  PubMed Central  Google Scholar 

  24. Holavanahalli RK, Helm PA, Kowalske KJ (2010) Long-term outcomes in patients surviving large burns: the skin. J Burn Care Res 31:631–639. https://doi.org/10.1097/BCR.0b013e3181e4ca62

    Article  PubMed  Google Scholar 

  25. Gellin GA, Epstein WL (1975) Malignant Melanoma from Thermal burn scar. Arch Dermatol 111:1214–1215. https://doi.org/10.1001/archderm.1975.01630210130023

    Article  CAS  PubMed  Google Scholar 

  26. Nancarrow JD (1979) Malignant melanoma arising in an unstable burn scar. Br J Plast Surg 32:135. https://doi.org/10.1016/0007-1226(79)90014-6

    Article  CAS  PubMed  Google Scholar 

  27. Muhlemann MF, Griffiths RW, Briggs JC (1982) Malignant melanoma and squamous cell carcinoma in a burn scar. Br J Plast Surg 35:474–477

    Article  CAS  PubMed  Google Scholar 

  28. Orlet HK, Still J, Law E, Gertler C (2001) Malignant melanoma in a burn scar. Ann Plast Surg 46:59–61

    Article  CAS  PubMed  Google Scholar 

  29. Goldberg NS, Robinson JK, Peterson C (1985) Gigantic malignant melanoma in a thermal burn scar. J Am Acad Dermatol 12:949–952. https://doi.org/10.1016/S0190-9622(85)70120-X

    Article  CAS  PubMed  Google Scholar 

  30. Walker AN, Walker GK (1989) Scar-associated malignant melanoma and squamous carcinoma in situ. South Med J 82:1419–1421. https://doi.org/10.1097/00007611-198911000-00020

    Article  CAS  PubMed  Google Scholar 

  31. Lee JY-Y, Kapadia SB, Musgrave RH, Futrell WJ (1992) Neurotropic malignant melanoma occurring in a stable burn scar. J Cutan Pathol 19:145–150. https://doi.org/10.1111/j.1600-0560.1992.tb01357.x

    Article  CAS  PubMed  Google Scholar 

  32. Ikeda I, Kageshita T, Ono T (1995) Multiple malignant melanoma and squamous-cell carcinoma in a burn scar. Dermatology 191:328–332. https://doi.org/10.1159/000246588

    Article  CAS  PubMed  Google Scholar 

  33. Park HJ, Lee DW, Choi SW, Cho BK, Cho MJ, Shim SI (1995) A case of Amelanotic Melanoma developing in a burn scar. Korean J Dermatology 33:339–343

    Google Scholar 

  34. Akiyama M, Inamoto N, Nakamura K (1997) Malignant melanoma and squamous cell Carcinoma Forming one Tumour on a burn scar. DRM 194:157–161. https://doi.org/10.1159/000246086

    Article  CAS  Google Scholar 

  35. Alconchel MD, Olivares C, Alvarez R (1997) Squamous cell carcinoma, malignant melanoma and malignant fibrous histiocytoma arising in burn scars. Br J Dermatol 137:793–798

    Article  CAS  PubMed  Google Scholar 

  36. Ghazi J, Hamouda B, Amor G, Emna E-J, Samira K, Amel BO, Khaled R (1999) Melanoma arising in burn scars: report of 3 observations and a literature review. Arch Dermatol 135:1551–a

    Article  Google Scholar 

  37. Gamatsi IE, Bailie FB, Srinivasan JR, McCulloch TA (2000) Malignant melanoma in a skin graft: burn scar neoplasm or a transferred melanoma? Br J Plast Surg 53:342–344. https://doi.org/10.1054/bjps.2000.3322

    Article  CAS  PubMed  Google Scholar 

  38. Spring PM, El-Naggar AK, Myers JN, Langstein HN (2001) Malignant melanoma arising within a burn scar case report and review of the literature. Ann Otol Rhinol Laryngol 110:369–376. https://doi.org/10.1177/000348940111000414

    Article  CAS  PubMed  Google Scholar 

  39. Hwang K, Han JY, Lee SI (2004) Multiple malignant melanomas at different burn scar areas: a Case Report. Dermatol Surg 30:562–565. https://doi.org/10.1111/j.1524-4725.2004.30179.x

    Article  PubMed  Google Scholar 

  40. Bero SM, Busam KJ, Brady MS (2006) Cutaneous melanoma arising in a burn scar: two recent cases and a review of the literature. Melanoma Res 16:71–76. https://doi.org/10.1097/01.cmr.0000194428.39525.87

    Article  PubMed  Google Scholar 

  41. Chun JK, Md ES, Md AK, Md RP, Md CW (2006) Desmoplastic amelanotic melanoma in an irradiated burn scar. Dermatol Surg 32:161–164

    Article  CAS  PubMed  Google Scholar 

  42. Hiscutt EL, Adams JR, Ryan JM, Langtry JAA, Natarajan S (2009) Atypical fibroxanthoma, lentigo maligna melanoma and squamous cell carcinoma arising in the site of a thermal burn treated with skin grafts. Br J Oral Maxillofac Surg 47:157–158. https://doi.org/10.1016/j.bjoms.2008.08.017

    Article  CAS  PubMed  Google Scholar 

  43. Atzeni M, Serratore F, Zaccheddu F, Buosi M, Nemolato S, Ribuffo D (2009) Multiple melanoma arising on a burn scar and extensive sunburn: a case report and a review of the literature. Melanoma Res 19:195–198. https://doi.org/10.1097/CMR.0b013e32832ccd3f

    Article  PubMed  Google Scholar 

  44. Sheff JS, Pane TA (2009) Spindle cell Melanoma arising from decades-old burn scar. Plast Reconstr Surg 124:274e. https://doi.org/10.1097/PRS.0b013e3181b98e1a

    Article  CAS  PubMed  Google Scholar 

  45. Ribero S, Grassi M, Caliendo V, Lauro D, Macripò G (2012) Melanoma arising on a scar 10 years after a burn: management and review of the literature. Ann Plast Surg 69:27–29. https://doi.org/10.1097/SAP.0b013e318250f084

    Article  CAS  PubMed  Google Scholar 

  46. Uchida S, Oiso N, Shiga K, Narita T, Kawada A (2016) Malignant melanoma on a Thermal burn scar with an interval of more than 70 years. CDE 8:207–209. https://doi.org/10.1159/000446837

    Article  Google Scholar 

  47. Cantwell P, Brooks A (2018) Multiple melanoma in a burns scar. BMJ Case Rep CP 11:e227295. https://doi.org/10.1136/bcr-2018-227295

    Article  Google Scholar 

  48. Serras RP, Rasteiro DC, Mendes MM, Mouzinho MM (2019) Melanoma Marjolin’s ulcer in the hand: a case report. Int J Surg Case Rep 60:345–347. https://doi.org/10.1016/j.ijscr.2019.06.029

    Article  PubMed  PubMed Central  Google Scholar 

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EM wrote the main manuscript text and prepared the table. SG prepared the figures. All authors edited and reviewed the manuscript.

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Correspondence to Jill Allbritton.

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Ma, E., Ge, S., Rush, W.L. et al. Malignant melanoma arising in a burn scar. Arch Dermatol Res 316, 146 (2024). https://doi.org/10.1007/s00403-024-02861-0

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