Abstract
BACKGROUND: Malignant transformation of chronic osteomyelitis is extremely rare. Squamous cell carcinoma (SCC) is the most frequently reported malignancy, with a latency period of 20-50 years after the onset of osteomyelitis. CASE PRESENTATION: A 61-year-old man presented with recurrent discharge from the left distal thigh 30 years after open femur fracture. Histopathology showed SCC arising from chronic osteomyelitis with bone invasion. The patient initially declined amputation but eventually consented to transfemoral amputation after symptom recurrence. TREATMENT AND OUTCOME: Intraoperative frozen section was utilized to determine the level of amputation. CONCLUSIONS: This case highlights the importance of definitive surgical treatment with amputation for SCC arising in chronic osteomyelitis, even after initial patient refusal. Recurrence should prompt the reconsideration of amputation.