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Malignant lesions arising in chronic osteomyelitis
J E McGrory1, D J Pritchard, K K Unni
1Mayo Clinic, Rochester, MN 55905, USA.
Clinical Orthopaedics and Related Research
|May 21, 1999
Summary
Neoplasia in sinus tracts is a complication of chronic osteomyelitis. Squamous cell carcinoma survival was similar to controls, yet amputation remains a common treatment for tumor and infection.
Area of Science:
- Oncology
- Orthopedic Surgery
- Pathology
Background:
- Neoplasia within a sinus tract is a recognized complication of chronic osteomyelitis.
- Previous studies lacked sufficient sample size for robust survival analysis.
Purpose of the Study:
- To analyze survival outcomes for patients with neoplastic transformation of sinus tracts secondary to chronic osteomyelitis.
- To evaluate treatment modalities and their effectiveness in this patient cohort.
Main Methods:
- Retrospective review of 53 consecutive patients diagnosed with neoplastic transformation of sinus tracts.
- Data collection included patient demographics, tumor type, treatment received (amputation vs. limb salvage), and survival status.
- Survival analysis was performed, comparing outcomes to age-matched controls.
Main Results:
- The majority of cases (50/53) were squamous cell carcinomas; others included fibrosarcoma, myeloma, and lymphoma.
- Mean patient age was 59 years, with a male predominance (44 men, 9 women).
- Overall survival for squamous cell carcinoma patients was comparable to age-matched controls, despite the low-grade nature of most lesions.
Conclusions:
- Neoplastic transformation of chronic osteomyelitis sinus tracts, predominantly squamous cell carcinoma, has a survival rate similar to the general population.
- Amputation is frequently employed as the primary treatment, balancing the management of both the malignancy and the underlying chronic infection.