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Carcinoma Arising in Scars, Osteomyelitis, and Fistulae

RALPH F. BOWERS, M.D.; J. M. YOUNG, M.D.
AMA Arch Surg. 1960;80(4):564-570. doi:10.1001/archsurg.1960.01290210032006.
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Celsus, who lived in the first century, noted the development of cancer in burn scars. The more recent interest in this subject began probably with the classic publication of Marjolin1 in 1828 concerning cancers arising in scars of many types.

Treves and Pack2 in 1930 estimated that about 2% of burn scars undergo malignant change, and they found that these usually occurred in the extremities and scalp. Their incidence figures for site of origin were 38% lower extremities, 22% upper extremities, 30% head and face, and 10% trunk. Broders3 has estimated that 24.5% of all cancer of the extremities arises in scars, but Arndt4 felt that a figure of 9% was more likely correct. Males outnumber females in a ratio of 3 to 1 in burn scar cancers, and all races have developed such tumors. Lawrence5 in 1952 accepted only 99 cases of burn scar

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