[Chronic osteomyelitis and cancer of the fistula].

Malignant change following chronic osteomyelitis with draining sinuses is rare (0.38-2.7%). The time from onset of osteomyelitis until malignant changes differs but needs 30 years in an average. Most patients are men between 50 and 60 years of age. If there is any doubt about malignancy (bleeding, tumor growth) biopsy should be performed and repeated if histological findings give no clear diagnosis. Metastases should be excluded by x-ray of the chest, scintigram and CT of the regional lymphnodes. Correct surgical therapy can only be done by amputation or exarticulation of the extremity. Patients who were operated upon malignant carcinoma of a sinus after osteomyelitis ought to be controlled in a regular follow-up including blood test (tumor marker).