Burns: Marjolin ulcer: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Burns: Marjolin ulcer

Sample item

A 55-year-old man has a non-healing, raised, ulcerated lesion with an everted edge within a burn scar on his thigh sustained 30 years ago. Which diagnosis must be excluded by biopsy?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Squamous cell carcinoma (Marjolin ulcer)

A Marjolin ulcer is a malignancy arising in chronic wounds, burn scars or osteomyelitis sinuses, most often squamous cell carcinoma, appearing after a long latent period. It tends to be aggressive but less likely to spread to lymph nodes because the scar has poor lymphatic drainage. Treatment is wide local excision with margins and reconstruction.

Option by option

  • A. Basal cell carcinoma

    Basal cell carcinoma is typically a rolled pearly lesion in sun-exposed skin and is not the usual scar malignancy.

  • B. Keloid

    A keloid is a benign raised scar that does not ulcerate with an everted edge.

  • C. Malignant melanoma

    Melanoma is not the typical neoplasm of chronic burn scars, which more often give squamous cell carcinoma.

  • D. Squamous cell carcinoma (Marjolin ulcer) (correct)

    Correct. A new ulcer in a long-standing burn scar is squamous cell carcinoma until proven otherwise.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Squamous cell carcinoma (Marjolin ulcer). A Marjolin ulcer is a malignancy arising in chronic wounds, burn scars or osteomyelitis sinuses, most often squamous cell carcinoma, appearing after a long latent period.

Why is "Basal cell carcinoma" not the answer?

Basal cell carcinoma is typically a rolled pearly lesion in sun-exposed skin and is not the usual scar malignancy.

Why is "Keloid" not the answer?

A keloid is a benign raised scar that does not ulcerate with an everted edge.

Why is "Malignant melanoma" not the answer?

Melanoma is not the typical neoplasm of chronic burn scars, which more often give squamous cell carcinoma.

What concept does this question test?

It tests Burns: Marjolin ulcer in General Surgery. It tends to be aggressive but less likely to spread to lymph nodes because the scar has poor lymphatic drainage. Treatment is wide local excision with margins and reconstruction.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Burns: Marjolin ulcer?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.