Cancer in old burn scars

Summary

30 cases of carcinoma in old burn scars, treated over a ten-year-period, are described. 24 of these were males, 6 were females. The time interval between the burn and evidence of carcinoma was from ten years to over forty. In all of our patients carcinoma was preceded by deep second and third degree burns, which healed without skin grafting and over a long period of time. The clinical presentation was in most cases a flat, indurated, ulcerating lesion with fairly regular edges; we found exophytic and papillary forms only in some. Histopathological investigation showed all lesions to be squamous-cell carcinoma. Lymphatic radiographic studies have been performed in patients with enlarged lymph nodes. In all patients a radical surgical procedure was performed: wide excision of the ulcerofibrous tissue with covering of the resulting defects, primarily or primarily delayed, with split-skin grafts. Where bone was involved, or on the foot, skin flaps were used. Dissection of inguinal lymph nodes was performed in three patients in which metastases were found histopathologically and by lymphangiography. Looking at the results, we find that 23 patients are free of recurrences in a follow-up of over ten years while 7 showed recurrences after 1–5 years.