Slovenská chirurgia 3/2012

Atypical decubital (bed sore) fibroplasia – a diagnostic and therapeutic challenge?

The aim of our work is to describe a rare nosological unit on a particular case of patient we´ve treated, with an atypical clinical course and to point at the possible consequences of inadequate treatment of bed sore (decubitus) and possibly incorrect pathologist´s diagnosis. Our paper describes a case of 45-year old patient after meningomyelocele surgery, with chronic kidney disease, after renal transplantation and subsequent graftnecrectomy. This patients had also bed sores in the femoro-popliteal region on the left side for a period of about three years, with abscess and osteomyelitis of ischiadic bone confirmed by CT scan, and at surgical revision there was revealed a tumour infiltration of the surrounding of the bed sore. Followed the progression of infection, phlegmona and gangrene of the leg, and this patient dies in severe sepsis despite surgical interventions and antibiotic therapy. The histological examination of tumorous infiltration discovered an atypical decubital (bed sore) fibroplasia. Conclusion is, that an atypical decubital fibroplasia is an extremely rare benign tumor in debilitated and physically deprived patients, which is to be thought about in a diagnostic process, because it can be mistaken for sarcoma.

Keywords: fibroplasia, atypical, bed sore (decubitus), sarcoma.