Malignant transformation is a rare and late complication of chronic osteomyelitis. This study presented the results of six cases of carcinogenesis and precancerosis transformations arising from chronic osteomyelitis.
Patients who were diagnosed as chronic osteomyelitis and treated in our division were retrospectively retrieved from electronic case system of our hospital. A total of six cases of chronic osteomyelitis patients, confirming with pathological results were included. Not only the characteristics and causes of chronic osteomyelitis, but also time from diagnosis to malignancy, histological types, therapeutic choices and results of treatment were fully incorporated to further study this disease.
All 6 cases with chronic osteomyelitis included in the study were male, with average age of 55.67 year-old (ranging from 48 to 66). The average time from onset of osteomyelitis to carcinomatous change was 31 years (ranging from 9 to 50). Two thirds of patients had explicit infection source of trauma, whereas the rest cases had no obvious culprits before osteomyelitis emerging. All 3 patients diagnosed as carcinoma were performed with proximal limb amputation, but therapy strategies varied in the remaining 3 patients in precancerosis stage. After amputation, 1 patient had carcinoma relapsed at the lower portion of his femur.
Although carcinomatous degeneration exists as a rare complication in chronic osteomyelitis, some suspicious conditions such as failure treatment of refractory ulcer and bulking of cauliflower-like mass should be taken cautiously. Early diagnosis and proximal amputation are essential for prognosis and clinical results.

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