Radiologic diagnosis of bone invasion of malignant lesions from chronic ulcers of the lower limbs
- VernacularTitle:下肢慢性溃疡癌变骨侵蚀的X线诊断
- Author:
Shenghui JIN
;
Hai LIU
;
Xiaoping PAN
- Publication Type:Journal Article
- Keywords:
Skin ulcer;
Carcinoma;
Osteomyelitis;
Radiograph
- From:
Chinese Journal of Orthopaedics
1999;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective By contrasting and analyzing the clinic manifestations, radiological features and pathological results of patients with bone invasion from skin of the lower limbs that were associated with malignancy, authors advanced X-ray diagnostic evidence to promote its diagnostic accuracy. Methods The radiological appearances of squamous cell carcinoma arising in chronic ulcers, sinus and scars of the lower limbs in 16 patients from February 1968 to April 2002 confirmed by pathology, were analyzed retrospectively. All cases were taken posterior-anterior and lateral radiograph before operation. There were 15 males and 1 females aging from 15 to 67 years (mean, 50.4 years). The lesion was located at the front of tibia in 15, and the middle inferior part of femur. The medical history of primary diseases varied from 1 to over 50 years with an average of 20 years and 3 months. Of 16 cases, the duration of 8 cases from a sudden change of state of an illness to the final diagnosis was 4 to 6 months, 4 cases above 1 year, and 4 cases were found with no any change of state of an illness. Results There were 14 cases observed as typical chronic osteomyelitis, which demonstrated peripheral osteolytic defect, 13 cases with osteolytic destruction spreading outwards from front of tibia, and 1 case with widespread osteolytic destruction in the middle and inferior part of femur. Floating-ice-like rudimental bone in the defect was found in 11 cases, and 4 case were observed with old fracture. 2 cases without obvious history of typical chronic osteomyelitis, 1 case with soft tissue trauma and 1 case of burn, showed small Saucer-like erosion of the cortex and huge lobar soft tissue masses. Moreover, patchy shadow and Codman's triangle were found in 1 case of burn. Furthermore, lobar soft tissue masses and huge ulcer accord with osteolytic destruction was observed in all cases, and soft tissue masses were larger than the area of bony destruction in 6 cases. Conclusion Roentgenogram could display shape, location and extension of bone invasion from skin of the lower limbs that were associated with malignancy, which contribute to diagnose the lesion and provide useful evidence for surgical plan.
