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股骨慢性骨髓炎引发的鳞状细胞癌:一例报告

Squamous cell carcinoma arising from chronic osteomyelitis of the femur: A case report.

作者信息

Jiang Nan, Yang Yu-Sheng, Lin Qing-Rong, Hu Yan-Jun, Yu Bin

机构信息

Division of Orthopedics and Traumatology, Department of Orthopedics, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, P.R. China.

Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, P.R. China.

出版信息

Biomed Rep. 2024 Mar 6;20(5):71. doi: 10.3892/br.2024.1759. eCollection 2024 May.

Abstract

Although chronic osteomyelitis (COM) affecting the extremities is a frequently occurring disease, the incidence of squamous cell carcinoma (SCC) arising from COM is rare. Consequently, understanding the diagnosis, treatment and prognosis of such a disorder remains limited. In the present study, a case of COM-associated SCC was demonstrated. A 65-year-old woman arrived to the Southern Medical University Nanfang Hospital (Guangzhou, China) with multiple sinus tracts and skin ulcers in the distal part of her left thigh, persisting for over 50 years following an open pierce injury by an ox horn. A local biopsy confirmed the diagnosis of COM-related SCC. Although limb amputation was recommended, the female patient declined initially. Instead, the female patient underwent focused debridement and wide resection of the tumor, followed by local implantation of calcium sulfate beads loaded with vancomycin and gentamycin, and application of a rail fixator. A total of 10 months later, the cancer recurred, affecting the osseous tissue. Subsequently, the patient underwent amputation of the thigh. At the one-year follow-up, the patient showed satisfactory recovery without signs of local recurrence. Despite its rarity, the severity of this disorder should not be underestimated. Personalized treatment strategies must be tailored to individual circumstances.

摘要

尽管影响四肢的慢性骨髓炎(COM)是一种常见疾病,但由COM引发的鳞状细胞癌(SCC)发病率却很低。因此,对于这种疾病的诊断、治疗和预后的了解仍然有限。在本研究中,展示了一例COM相关的SCC病例。一名65岁女性因左大腿远端出现多个窦道和皮肤溃疡来到南方医科大学南方医院(中国广州),这些症状在被牛角开放性刺伤后持续了50多年。局部活检确诊为COM相关的SCC。尽管建议进行肢体截肢,但该女性患者最初拒绝了。相反,该女性患者接受了肿瘤的局部清创和广泛切除,随后局部植入负载万古霉素和庆大霉素的硫酸钙珠,并应用了轨道固定器。总共10个月后,癌症复发,累及骨组织。随后,患者接受了大腿截肢手术。在一年的随访中,患者恢复良好,没有局部复发的迹象。尽管这种疾病罕见,但不应低估其严重性。必须根据个体情况制定个性化的治疗策略。

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