Malignancy in chronic osteomyelitis of the foot and ankle (case series)

Kliushin N.M., Sudnitsyn A.S., Migalkin N.S., Stupina T.A., Suvorov N.R.

Abstract


Introduction
Carcinomatous degeneration is a severe complication of chronic osteomyelitis. The exact mechanism of the malignant transformation remains unknown. This degeneration most often results from squamous cell carcinoma arising in chronic osteomyelitis. Early diagnosis and appropriate treatment are essential for prognosis and final results in carcinomatous degeneration secondary to chronic osteomyelitis. Definitive treatment of chronic osteomyelitis and antimicrobial therapy are thought to be effective in prevention of malignant changes.
Objective
To identify diagnostic criteria for neoplastic disease in chronic osteomyelitis.
Methods
We reviewed 7 (2.75 %) patients aged 39 to 65 years who were treated for relapse of bone infection at the Clinic of Osteology Infection between 2017 and 2018. The average duration of the disease was 36 ± 6.42 years. A comprehensive examination performed for the patients on admission included radiographs of the involved limb segment, microbiological analysis of wound discharge, complete blood count, serum biochemistry panels, Doppler ultrasonography of the lower limb arteries and an excisional biopsy.
Results
Squamous cell carcinoma was diagnosed in the feet of all patients.
Discussion
The examinations performed were useful for identifying several diagnostic criteria for neoplastic process associated with pseudocarcinomatous hyperplasia in chronic osteomyelitis.

Keywords


chronic osteomyelitis in the foot, malignancy, squamous cell carcinoma, diagnosis of squamous cell carcinoma

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DOI: http://dx.doi.org/10.18019/1028-4427-2019-25-4-517-522

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