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.
Highlights
Carcinomatous degeneration is a severe complication of chronic osteomyelitis [1–5]
Squamous cell carcinoma is the most common type of malignant tumor resulting from chronic osteomyelitis
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
Summary
The exact mechanism of the malignant transformation remains unknown. This degeneration most often results from squamous cell carcinoma arising in chronic osteomyelitis. Squamous cell carcinoma is the most common type of malignant tumor resulting from chronic osteomyelitis. The exact mechanism of the malignant transformation remains unknown and is assumed multifactorial. Inflammation, especially chronic one, is the definite cause for tumor development and progression, and it is well referred to as inflammation-related carcinogenesis. In these conditions, the immune system is dysregulated: inflammatory mediators and cytokines expressed by the immune system modulate the genic expression of various proteins, including p53. The duration of osteomyelitis appears to be the principal factor related to carcinogenesis onset, with a minimum latency period of 20 years or more [4]
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