ArticleInfection and drug resistance2026
Squamous Cell Carcinoma Arising from Chronic Osteomyelitis: A Single-Center Case Series of Six Patients.
Article in Infection and drug resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chronic osteomyelitis (COM) is a persistent bone infection. Long-standing COM may lead to malignant transformation, most commonly squamous cell carcinoma (SCC). However, due to its rarity and nonspecific clinical presentation, early diagnosis remains challenging. This study aimed to characterize the clinical features, microbiological profiles, management strategies, and outcomes of SCC arising from COM. Patients and Methods: We retrospectively reviewed six consecutive patients diagnosed with SCC secondary to COM at Shanghai Sixth People's Hospital from January 2021 up to May 2026. Diagnosis was confirmed histopathologically. Demographic data, duration and etiology of osteomyelitis, clinical manifestations, microbiological findings, imaging features, treatment approaches, and follow-up outcomes were systematically analyzed. Results: Six patients (three men and three women) with a median age of 57.5 years (interquartile range, 48.2-61.5) were included. The median duration of osteomyelitis before malignant transformation was 12 years. Lesions were predominantly located in the lower extremities (5/6, 83.3%), and one case involved the thumb (1/6, 16.7%). The most common symptoms included purulent discharge, pain and ulceration. Microbiological analysis revealed a predominance of Gram-negative organisms, including Conclusion: SCC should be suspected in patients with long-standing COM with worsening ulceration, increased discharge, or mass formation. Early biopsy is essential for a definitive diagnosis. The observed predominance of Gram-negative pathogens within this cohort generates a hypothesis regarding potential links between microbial characteristics and malignant transformation. Radical surgery, including amputation, achieves effective local disease control. Timely identification of malignant change may offer opportunities for limb-sparing treatment and improved functional outcomes.
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