Mohammed ALAMI, Mustapha MAHFOUD, Ahmet EL BARDOUNI, Mohamed Saleh BERRADA, Moradh EL YAACOUBI

Kronik osteomiyelit zemininde gelişen skuamoz hücreli karsinom

Amaç: Çalışmamızda kronik osteomiyelit zemininde skuamoz hücreli karsinom gelişen 7 hastamızın sonuçlarını değerlendirmeyi amaçladık. Çalışma planı: 1993-2005 yıllan arasında kronik osteomiyelit tanılı 7 hasta tedavi edildi. Hastaların ortalama yaşı 54.5 (dağılım: 38-71) idi ve erkekler çoğunluktaydı (6 erkek, 1 kadın). Çalışmamızda kanser oluşumuna kadar geçen süre, karsinomun lokalizasyonu ve histopatolojik türü ve tedavi sonuçları incelendi. Bulgular: Lezyonlann oluşumu ile habis dejenerasyon tanısı arasında geçen süre ortalama 24.5 (dağılım: 9-40) yıl idi. Karsinom 4 hastada tibia osteomiyeliti, 2 hastada femur osteomiyeliti ve 2 hastada da humerus osteomiyeliti zemininde oluşmuştu. Patolojik incelemede 5 olguda kemik yayılımlı iyi diferansiye skuamoz hücreli karsinom ve 2 olguda invazif skuamoz hücreli karsinom tespit edildi. Reddeden biri hariç tüm hastalar ampütasyonla tedavi edildi. Altı ampüte hastada beş yıllık süre içinde lokal nüks veya metastaz görülmedi. Çıkarımlar: Ampütasyon kronik osteomiyelit kaynaklı skuamoz hücreli karsinoma karşı etkin bir tedavi yöntemi olarak görünmektedir.

Anahtar Kelimeler:

Cinsiyet faktörleri, Hücre değişimi, neoplastik, Kronik hastalık, Zaman, Alt ekstremite, Osteomiyelit, Geriyedönük çalışma, Tedavi sonucu, Karsinom, yassı hücreli, Ampütasyon

Squamous cell carcinoma arising from chronic osteomyelitis

Objectives: Our aim was to present the results from a retrospective study of 7 cases of squamous cell carcinoma arising from chronic osteomyelitis. Methods: We treated seven cases of chronic osteomyelitis related squamous cell carcinoma between 1993 and 2005. The patients had an average age of 54.5 (range: 38-71) years, with a male predominance (6 men, 1 woman). We analyzed the time up to cancerization, the localiza tion and histopathological type of the carcinoma, and the type and result of the treatment. Results: The mean time between the occurrence of the skin lesions and the diagnosis of malig nant degeneration was 24.5 (range: 9 to 40) years. The carcinoma resulted from tibia osteomyelitis in 4 cases, femur osteomyelitis in 2 cases and humerus osteomyelitis in one. The pathological examination showed five cases of a well differentiated squamous cell carcinoma with bone inva sion, and two cases of invasive squamous cell carcinoma. The treatment consisted of amputation in all but one patient, who refused the amputation. The six amputee patients did not show local recurrence or metastatic dissemination over a period of five years. Conclusion: Amputation appears to be an effective treatment method in squamous carcinoma secondary to chronic osteomyelitis.

Keywords:

Sex Factors, Cell Transformation, Neoplastic, Chronic Disease, Time, Lower Extremity, Osteomyelitis, Retrospective Studies, Treatment Outcome, Carcinoma, Squamous Cell, Amputation,

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