CC BY-NC-ND 4.0 · Avicenna J Med 2020; 10(03): 128-131
DOI: 10.4103/AJM.AJM_156_19
Case Report

Giant-neglected facial Marjolin’s ulcer associated with perioperative blood loss anemia

Ahmad Kaako
Department of Medicine, Mercy Hospital, Fort Smith, AR, USA
Ratna M Malkan
Arkansas College of Osteopathic Medicine (ARCOM), Fort Smith, Arkansas, USA
Cassidy P Goff
Arkansas College of Osteopathic Medicine (ARCOM), Fort Smith, Arkansas, USA
› Author Affiliations

Subject Editor: Financial support and sponsorship Nil.


Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer in humans after basal cell carcinoma. Marjolin’s ulcer is a form of cutaneous malignancy, and mostly represents cSCC, arising from chronic burns and wounds. We describe an interesting case of giant-neglected facial Marjolin’s ulcer identified as cSCC associated with perioperative blood loss anemia. We also highlight its staging workup and the treatment options provided.

Publication History

Article published online:
04 August 2021

© 2020. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

  • References

  • 1 Nehal KS, Bichakjian CK. Update on keratinocyte carcinomas. N Engl J Med 2018; 379: 363-74
  • 2 Wollina U, Bayyoud Y, Krönert C, Nowak A. Giant epithelial malignancies (basal cell carcinoma, squamous cell carcinoma): A series of 20 tumors from a single center. J Cutan Aesthet Surg 2012; 5: 12-9
  • 3 Xiang F, Song HP, Huang YS. Clinical features and treatment of 140 cases of Marjolin’s ulcer at a major burn center in southwest china. Exp Ther Med 2019; 17: 3403-10
  • 4 Baumeister P, Canis M, Reiter M. Preoperative anemia and perioperative blood transfusion in head and neck squamous cell carcinoma. PLoS One 2018; 13: e0205712
  • 5 Kabir S, Schmults CD, Ruiz ES. A review of cutaneous squamous cell carcinoma epidemiology, diagnosis, and management. Int J Cancer Manage 2018; 11: e60846
  • 6 Kang SY, Toland AE. High risk cutaneous squamous cell carcinoma of the head and neck. World J Otorhinolaryngol Head Neck Surg 2016; 2: 136-40
  • 7 Vidimos A, Stultz T. Evaluation for locoregional and distant metastases in cutaneous squamous cell and basal cell carcinoma. UpToDate 2019. Available from: [Last accessed on 2019 Aug 21].