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Malignant transformation of chronic osteomyelitis: a case report.

Abstract Malignant transformation of chronic osteomyelitis is a rare and late complication which mainly occurs at the level of the edges of a fistulous tract with extension and infiltration to the surrounding soft tissues and more rarely to bones. We here report the case of Mr N.J. aged 67 years, followed up for chronic osteomyelitis of the right femur fistulized to the skin and evolving since the age of 16 years. He presented with secerning fistulas. Imaging examination showed pathologic fracture due to osteolytic lesion of the lower extremity of the right femur associated with poorly defined intra-medullary collection of fluid measuring 8 cm along its longer axis. The patient underwent surgical resection of the fistulas with complete evacuation and curettage of the bone cavity. Pathological examination showed differentiated keratinising squamous cell carcinoma, infiltrating the fistulous tract and extending to the soft parts and to the lower extremity of the right femur. Staging was negative. Disarticulation of the HIP was performed. At two-years follow-up the patient was doing well without local recurrence or distant metastasis. Initial treatment of chronic osteomyelitis is essential to prevent alarming complications. Amputation is the treatment of choice in patients with malignant transformation of chronic osteomyelitis in particular to squamous cell carcinoma, as in the case of our patient, in order to to prevent secondary involvement.
PMID
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Authors

Mayor MeshTerms
Keywords

Chronic osteomyelitis

amputation

femur

malignant transformation

squamous cell carcinoma

Journal Title the pan african medical journal
Publication Year Start




PMID- 29599886
OWN - NLM
STAT- MEDLINE
DCOM- 20180405
LR  - 20180405
IS  - 1937-8688 (Electronic)
VI  - 28
DP  - 2017
TI  - [Malignant transformation of chronic osteomyelitis: a case report].
PG  - 188
LID - 10.11604/pamj.2017.28.188.13741 [doi]
AB  - Malignant transformation of chronic osteomyelitis is a rare and late complication
      which mainly occurs at the level of the edges of a fistulous tract with extension
      and infiltration to the surrounding soft tissues and more rarely to bones. We
      here report the case of Mr N.J. aged 67 years, followed up for chronic
      osteomyelitis of the right femur fistulized to the skin and evolving since the
      age of 16 years. He presented with secerning fistulas. Imaging examination showed
      pathologic fracture due to osteolytic lesion of the lower extremity of the right 
      femur associated with poorly defined intra-medullary collection of fluid
      measuring 8 cm along its longer axis. The patient underwent surgical resection of
      the fistulas with complete evacuation and curettage of the bone cavity.
      Pathological examination showed differentiated keratinising squamous cell
      carcinoma, infiltrating the fistulous tract and extending to the soft parts and
      to the lower extremity of the right femur. Staging was negative. Disarticulation 
      of the HIP was performed. At two-years follow-up the patient was doing well
      without local recurrence or distant metastasis. Initial treatment of chronic
      osteomyelitis is essential to prevent alarming complications. Amputation is the
      treatment of choice in patients with malignant transformation of chronic
      osteomyelitis in particular to squamous cell carcinoma, as in the case of our
      patient, in order to to prevent secondary involvement.
FAU - Hamdani, Moez
AU  - Hamdani M
AD  - Laboratoire d'Anatomie et de Cytologie Pathologiques, Hopital Habib Bourguiba -
      Medenine, Medenine, Tunisie.
FAU - Houidi, Ali
AU  - Houidi A
AD  - Service d'Orthopedie, Hopital Habib Bourguiba - Medenine, Medenine, Tunisie.
FAU - Briki, Amine
AU  - Briki A
AD  - Service d'Orthopedie, Hopital Habib Bourguiba - Medenine, Medenine, Tunisie.
FAU - Haddad, Naoufel
AU  - Haddad N
AD  - Service d'Orthopedie, Hopital Habib Bourguiba - Medenine, Medenine, Tunisie.
FAU - Khabir, Abdelmajid
AU  - Khabir A
AD  - Laboratoire d'Anatomie et de Cytologie Pathologiques, Hopital Habib Bourguiba -
      Medenine, Medenine, Tunisie.
LA  - fre
PT  - Case Reports
PT  - Journal Article
TT  - Osteomyelite chronique compliquee d'un carcinome epidermoide: a propos d'une
      observation.
DEP - 20171031
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
SB  - IM
MH  - Aged
MH  - Bone Neoplasms/*diagnosis/surgery
MH  - Carcinoma, Squamous Cell/*diagnosis/pathology/surgery
MH  - Cell Transformation, Neoplastic
MH  - Chronic Disease
MH  - Cutaneous Fistula/pathology
MH  - Follow-Up Studies
MH  - Fractures, Spontaneous/diagnosis/pathology
MH  - Humans
MH  - Male
MH  - Osteomyelitis/*complications/pathology
MH  - Skin Neoplasms/diagnosis/pathology
PMC - PMC5871255
OTO - NOTNLM
OT  - Chronic osteomyelitis
OT  - amputation
OT  - femur
OT  - malignant transformation
OT  - squamous cell carcinoma
EDAT- 2018/03/31 06:00
MHDA- 2018/04/06 06:00
CRDT- 2018/03/31 06:00
PHST- 2017/08/30 00:00 [received]
PHST- 2017/09/25 00:00 [accepted]
PHST- 2018/03/31 06:00 [entrez]
PHST- 2018/03/31 06:00 [pubmed]
PHST- 2018/04/06 06:00 [medline]
AID - 10.11604/pamj.2017.28.188.13741 [doi]
AID - PAMJ-28-188 [pii]
PST - epublish
SO  - Pan Afr Med J. 2017 Oct 31;28:188. doi: 10.11604/pamj.2017.28.188.13741.
      eCollection 2017.