Malignancy transformation of chronic osteomyelitis:description of 6 cases of Marjolin’s ulcers
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Julia Steinrücken · Maria-Chiara Osterheld ·Andrej Trampuz · Olivier Borens
- چاپ و سال / کشور: 2011
Description
Background Marjolin’s ulcer describes any malignant transformation of a chronic inXammatory lesion. In the majority of cases, a squamous cell carcinoma is diagnosed. Malignant transformation occurs usually after a long period of latency of chronic infection; it takes approximately 35 years on average. There are no typical clinical presentations, but several indirect signs may suggest the malignant transformation, such as increased or changed discharge, pathologic fracture, a slow-growing exophytic mass, or other suggestive signs of malignant transformation, which should prompt to biopsy for histological exam. The diagnosis of chronic osteomyelitis should not prevent to search for carcinoma. Case description We present six patients with chronic osteomyelitis that developed well-diVerentiated squamous cell carcinoma. All patients were older than 50 years (mean 60 years, range 52–77 years). Five Marjolin’s ulcers were located on the lower limb and one on the arm. The average time of the chronic discharging osteomyelitis before diagnosis of carcinoma ranged between 12 and 40 years. All patients were treated by amputation of the aVected limb. None had metastasis, and one patient developed local recurrence and received palliative treatment. Clinical relevance Our study emphasizes that Marjolin’s ulcer should be considered as a rare but signiWcant longterm complication of chronic osteomyelitis. The Wnding of microorganisms should not prevent from further diagnostic procedures by histopathological examination so that the correct surgical treatment can be performed
Eur J Orthop Surg Traumatol DOI 10.1007/s00590-011-0794-x Received: 16 September 2010 / Accepted: 22 March 2011
