Malignant lesions arising in chronic osteomyelitis.

Neoplasia occurring in a sinus tract is a well known complication of chronic osteomyelitis. Previous series have been too small to permit survival analysis. Fifty-three consecutive patients (44 men and 9 women) from the authors' institution were reviewed, including 24 who previously were reported. There were 50 patients with squamous cell carcinomas, one with fibrosarcoma, one with myeloma, and one with lymphoma. Mean age was 59 years. One patient sought treatment elsewhere and was lost to followup. Forty-four patients underwent amputation, and eight underwent limb salvage. Followup averaged 9 years. Of 50 patients with squamous cell carcinoma, five died of disease. Overall survival in this group was not statistically different from that expected for age matched controls. Despite the low grade nature of most of these lesions, amputation often is chosen as the most reliable means of treating the tumor and the chronic infection.