Skip to main content
SpringerLink
Log in

Verrucous carcinoma of the tibia arising after chronic osteomyelitis: a case report

Verruköses Karzinom der Tibia bei chronischer Osteomyelitis

  • Case report
  • Published:
Wiener klinische Wochenschrift Aims and scope Submit manuscript

Zusammenfassung

Das verruköse Karzinom ist eine seltene Komplikation der chronischen Osteomyelitis. Die Inzidenz von Fistelkarzinomen beträgt zwischen 0,21% und 3,36%. Berichtet wird der Fall eines Patienten mit seit rund 58 Jahren bestehender chronischer Osteomyelits der Tibia, der ein verruköses Fistelkarzinom entwickelt hat. Die Hauptsymptome bestanden aus einer Zunahme der Schmerzen, übelriechender und eitriger Sekretion und einer Vergrößerung der Hautläsion. Es wurden moderne diagnostische Untersuchungen (Probebiopsie, Computertomographie, Angiographie, Magnetresonanztomographie und Immunoszintigraphie) durchgeführt um die Ausdehnung der malignen Läsion zu bestimmen. Es fanden sich keine lokalen oder entfernten Metastasierungen. Durch eine Knieexartikulation wurde eine erfolgreiche Therapie der chronischen Infektion und des Tumors erzielt.

Summary

Verrucous carcinoma is an uncommon complication of chronic osteomyelitis. The incidence of fistular carcinomas is reported to be between 0.21% and 3.36%. We present a case of verrucous carcinoma of the tibia arising after 58 years of chronic osteomyelitis. The primary presenting symptoms were acute pain, foul-smelling pus discharge and increasing lesion size. We used modern diagnostic investigations (biopsy, computed tomography, angiography, immunoscintigraphy, magnetic resonance tomography) to visualize the extent of the malignant lesion. No metastases were detected. Knee exarticulation was successful in treating the tumor and chronic infection in this case.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Ackerman LV (1948) Verrucous carcinoma of the oral cavity. Surgery 23: 670–678

    CAS  PubMed  Google Scholar 

  • Durox H, Roux C, Sparsa A, Labrousse F, Bedane C, Bonnetblanc JM (2007) Verrucous carcinoma of the lower limbs. Ann Dermatol Venereol 134 (6–7): 543–547

    Article  CAS  PubMed  Google Scholar 

  • Marjolin JN (1828) Ulcere dictionaire de médicine. Paris

  • Braun W, Krumme H, Rüter A (1983) Fistelkarzinom als Komplikation der chronischen Osteomyelitis. Münch Med Wochenschr 125: 819–821

    CAS  Google Scholar 

  • Lenz O, Plogmeier K, Fansa H, Schneider W (2001) Die chirurgische Behandlung des Narbenkarzinoms – Methoden und Ergebnisse. Chirurg 72: 690–698

    Article  CAS  PubMed  Google Scholar 

  • Tiemann A, Bosse A, Muhr G (1997) Das Fistelkarzinom als Komplikation der chronischen Osteomyelits. Chir Praxis 53: 129–136

    Google Scholar 

  • Wickenhauser C, Tsironis K, Zirbes TK, Larena-Avellanda A, Dienes HP (1999) Hochdifferenziertes Plattenepithelkarzinom als Spätkarzinom einer posttraumatischen Osteomyelitis. Pathologe 20: 236–241

    Article  CAS  PubMed  Google Scholar 

  • Fitzgerald RH, Brewer NS, Dahlin DC (1976) Squamous-cell carcinoma complicating chronic osteomyelitis. J Bone Joint Surg Am 58: 1146–1148

    PubMed  Google Scholar 

  • McGrory JE, Pritchard DJ, Unni KK, Ilstrup D, Rowland CM (1999) Malignant lesions arising in chronic osteomyelitis. Clin Orthop Relat Res 362: 181–189

    Article  PubMed  Google Scholar 

  • Burns HP, Van Nostrand AWP, Palmer JA (1980) Verrucous carcinoma of the oral cavity. Management by radiotherapy and surgery. Can J Surg 23: 19–21

    CAS  PubMed  Google Scholar 

  • Aydogan LB, Ozdemir S, Gumurdula D (2008) Verrucous carcinoma of the temporal bone. Am J Otolaryngol 29 (1): 69–71

    Article  PubMed  Google Scholar 

  • Shimizu A, Tamura A, Ishikawa O (2006) Invasive squamous cell carcinoma arising from verrucous carcinoma. Recognition of verrucous carcinoma of skin as an in situ carcinoma. Eur J Dermatol 16 (4): 439–442

    CAS  PubMed  Google Scholar 

  • Medina JE, Dichtel W, Luna MA (1984) Verrucous-squamous carcinomas of the oral cavity: a clinicopathologic study of 104 cases. Arch Otolaryngol 110: 437–440

    Article  CAS  PubMed  Google Scholar 

  • Biller MF, Bergman LA (1975) Verrucous carcinoma of larynx. Laryngoscope 85: 1698–1700

    Article  CAS  PubMed  Google Scholar 

  • Tharp II ME, Shidnia H (1995) Radiotherapy in the treatment of verrucous carcinoma of the head and neck. Laryngoscope 105: 391–396

    Article  PubMed  Google Scholar 

  • Burns HP, Van Nostrand AWP, Palmer JA (1980) Verrucous carcinoma of the oral cavity. Management by radiotherapy and surgery. Can J Surg 23: 19–21

    CAS  PubMed  Google Scholar 

  • Akbarnia BA, Wirth CR, Colman N (1976) Fibrosarcoma arising from chronic osteomyelitis. Case report and review of the literature. J Bone Joint Surg Am 58: 123–125

    CAS  PubMed  Google Scholar 

  • Bauer T, David T, Rimareix F, Lortat-Jacob A (2007) Marjolin's ulcer in chronic osteomyelitis: seven cases and a review of the literature. Rev Chir Orthop Reparatrice Appar Mot 93 (1): 63–71

    Article  CAS  PubMed  Google Scholar 

  • Sadat-Ali M, Geeranavar SS (1996) Malignancy in chronic osteomyelitis sinus. Report of three cases. Indian J Cancer 33 (3): 139–144

    CAS  PubMed  Google Scholar 

  • Smith J, Mello LF, Nogueira Neto NC, Meohas W, Pinto LW, Campos VA, et al (2001) Malignancy in chronic ulcers and scars of the leg (Marjolin's ulcer): a study of 21 patients. Skeletal Radiol 30 (6): 331–337

    Article  CAS  PubMed  Google Scholar 

  • Esther RJ, Lamps L, Schwartz HS (1999) Marjolin ulcers: secondary carcinomas in chronic wounds. J South Orthop Assoc 8 (3): 181–187

    CAS  PubMed  Google Scholar 

  • Cappello JC, Donick II (1981) Squamous cell carcinoma as a complication of chronic osteomyelitis. J Foot Surg 20 (3): 136–141

    CAS  PubMed  Google Scholar 

  • Sheen YS, Sheen MC, Sheu HM, Yang SF, Wang YW (2003) Squamous cell carcinoma of the big toe successfully treated by intra-arterial infusion with methotrexate. Dermatol Surg 29 (9): 982–983

    PubMed  Google Scholar 

  • Batinac T, Zamolo G, Coklo M, Maricic A, Bosnar A, Muhvic D (2006) Invasive carcinoma developing in condylomata gigantea Buschke-Löwenstein. Wien Klin Wochenschr 118 (3–4): 81

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Trauma Surgery, Medical University Vienna, Vienna, Austria

    Harald Wolf, Patrick Platzer & Vilmos Vécsei

Authors
  1. Harald Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patrick Platzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vilmos Vécsei
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Harald Wolf.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wolf, H., Platzer, P. & Vécsei, V. Verrucous carcinoma of the tibia arising after chronic osteomyelitis: a case report. Wien Klin Wochenschr 121, 53–56 (2009). https://doi.org/10.1007/s00508-008-1104-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-008-1104-4

Keywords

Search

Navigation