Cancer may be the cause of a non healing wound, ulcers, Marjolin’s ulcer, basal cell cancer, BCC, squamous cell cancer, SCC, skin metastasis, Malignant melanoma, malignancy Dr Alexander, plastic surgeon, cosmetic surgery, Cochin, Kerala, India+

One of the causes of an ulcer or wound that fails to heal and keep on slowly increasing may be cancer or malignancy. Cancers can develop primarily in the skin like the Basal cell carcinoma or squamous cell carcinoma. Malignant melanoma is another cancer that usually starts as a pigmented lesion. Basal cell cancers are more localized while squamous cell cancer and malignant melanoma can spread rapidly. Sometimes the cancer may start inside the body and spread as secondaries to the skin. In such cases we need to find out the primary source as well if the cancer has to be treated adequately.  

The cancerous cells multiply from some signals and the  body is unable to stop this multiplication. However they increase and reach a stage where the blood flow cannot reach the cells adequately and so some of the cells start to die or form an ulcer or wound. While a cancer or malignancy can end up as an ulcer, a chronic wound can sometimes end up developing a cancer possibly due to the tissue being repeatedly damaged in the wound which excites the cells to multiply rapidly. Sometimes when there is a long standing scar (scar of many years) following burns or any other causes which is unhealthy (skin tends to breakdown often) a cancer can develop. This cancer that develops in the scar tissue or wound is called ‘Marjolins ulcer’.

When a cancer is suspected often a ‘biopsy’ will confirm it. The surgeon will either take a small part of the wound edge (incision biopsy) or if the ulcer is small –completely excise (excision biopsy) the ulcer. The pathologist can examine the tissue immediately while the surgery is ongoing – (frozen section) and give the surgeon a clue that the tissue is malignant or not. This will help the surgeon to decide how much area (free margin) he should excise (cut out) around the wound, as well as the depth, so the cancer is completely excised. In other cases the surgeon may decide to excise the wound and get the definite biopsy report (paraffin section) after a week or two with all tests confirming the nature and diagnosis of the cancer and then decide whether further surgery is needed.