Malignancy transformation of chronic osteomyelitis: description of 6 cases of Marjolin's ulcers

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Serval ID
serval:BIB_FB1128D477E2
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Malignancy transformation of chronic osteomyelitis: description of 6 cases of Marjolin's ulcers
Journal
European Journal of Orthopaedic Surgery and Traumatology
Author(s)
Steinrücken J., Osterheld M.C., Trampuz A., Borens O.
ISSN
1633-8065
ISSN-L
1432-1068
Publication state
Published
Issued date
2012
Volume
22
Number
6
Pages
501-505
Language
english
Notes
UP-TO DATE REVIEW AND CASE REPORT.
Abstract
Marjolin's ulcer describes any malignant transformation of a chronic inflammatory 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.
We present six patients with chronic osteomyelitis that developed well-differentiated 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 affected limb. None had metastasis, and one patient developed local recurrence and received palliative treatment.
Our study emphasizes that Marjolin's ulcer should be considered as a rare but significant long-term complication of chronic osteomyelitis. The finding of microorganisms should not prevent from further diagnostic procedures by histopathological examination so that the correct surgical treatment can be performed.
Web of science
Open Access
Yes
Create date
22/01/2013 14:30
Last modification date
01/10/2019 7:20
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