TOTBİD Dergisi

TOTBİD Dergisi

2020, Cilt 19, Sayı, 5     (Sayfalar: 786-791)

Malignant transformation

Bahtiyar Demiralp 1, Çağrı Neyişci 1, Ahmet Burak Bilekli 1

1 Gülhane Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara

DOI: 10.14292/totbid.dergisi.2020.96
Görüntüleme: 319
İndirme : 372

Infection following high-energy trauma can occur due to soft tissue problems, poor bone tissue vascularization, immune- compromised patient, and virulent and/or resistant organisms. All of these factors compromise healing and can potentially lead to a chronic, treatment-resistant osteomyelitis. Malignant transformation as a result of chronic osteomyelitis is a relatively rare and late complication with a decreasing incidence in the modern world. For most patients, the period between the onset of bacterial infection and malignant transformation is several years. A chronic draining sinus should constitute a high degree of clinical suspicion for the diagnosis of malignant transformation. Biopsy should be planned immediately, especially in cases of new clinical manifestations such as increased pain, bad odor and changes in wound discharge. Early diagnosis and aggressive management of malignant transformation originating from chronic osteomyelitis site is critical for prognosis and the final outcome. Squamous cell carcinoma is the most common malignancy. The definitive treatment is amputation proximal to the tumor or wide excision with adjuvant chemotherapy and radiotherapy in selected patients. Early diagnosis may sometimes allow en bloc excision and limb-sparing surgery. However, the most effective treatment is the prevention of osteomyelitis by adequate debridement, extensive excision of the affected area and early reconstruction.

Anahtar Kelimeler : osteomyelitis; malignant transformation; Marjolin`s ulcer