The development of carcinoma in chronic osteomyelitic sinuses not only is uncommon but is very little appreciated by the dermatologist. The condition is well known to surgeons, however, and has been recognized for many years. Similar malignant degeneration may occur in tuberculous sinuses and also in chronic bronchial, biliary and anal fistulas, where an ingrowth of cutaneous epithelium to line the fistulas is not uncommon.
Credit for the first report of the development of carcinoma in osteomyelitic sinuses is somewhat difficult to assign. Dittrich1 reported an authentic case in 1847, but it is probable that in 1 of the cases described by Hawkins2 in 1835, under the title "Cases of Warty Tumors in Cicatrices," carcinoma had followed osteomyelitis. In the next forty to fifty years a number of reports appeared, and in 1891 Borchers3 collected reports of 20 cases from the literature and added reports of 5