Sankaran-Kutty M, Corea J R, Ali M S, Kutty M K
Clin Orthop Relat Res. 1985 Sep(198):264-7.
Malignant change at the site of a chronic osteomyelitis, a rare condition, is reported in a 45-year-old man, along with a review of the literature. This patient with a 30-year history of chronic osteomyelitis of the right femur and an intermittently discharging sinus had a large abscess in the lower thigh. The abscess was drained, and an ulcer developed at the mouth of the sinus tract. Soon afterward, he sustained a pathologic fracture through the lower femur. Biopsy specimens of the ulcer showed a well-differentiated squamous carcinoma. An amputation was performed at the level of the proximal 10 cm of the femur. The patient remains well 18 months later with no clinical or radiologic evidence of metastases. Changes in character of a previously innocuous osteomyelitis sinus tract should arouse suspicion of neoplastic transformation. Biopsy of various depths of the sinus tract, including the bone marrow, is essential. Early amputation for squamous cell carcinoma is indicated and offers a good prognosis.
报道了一名45岁男性患有慢性骨髓炎部位的恶性病变（一种罕见情况），并对相关文献进行了综述。该患者有右股骨慢性骨髓炎30年病史，伴有间歇性排脓窦道，大腿下部有一个大脓肿。脓肿引流后，窦道口出现溃疡。此后不久，他的股骨下部发生病理性骨折。溃疡的活检标本显示为高分化鳞状癌。在股骨近端10厘米处进行了截肢手术。18个月后患者情况良好，无临床或影像学转移证据。先前无害的骨髓炎窦道特征改变应引起对肿瘤转化的怀疑。对窦道不同深度（包括骨髓）进行活检至关重要。对于鳞状细胞癌，早期截肢是必要的，且预后良好。
