A Case Report of Venous Ulcer with Multiple Heterotopic Ossifications in Soft Tissue

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  • 軟部組織内に多発異所性骨化を伴った静脈性潰瘍の1 例

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Abstract

As a rule, it is necessary to reduce increased venous pressure in soft skin tissue in the treatment of venous ulcers of the lower limbs. However, ulcer healing is not achieved in some patients, requiring soft skin tissue reconstruction. The patient was a 68-year-old male. He was referred to our department with the diagnosis of a recurrent venous ulcer of the right medial malleolus, which had repeatedly recurred during the past 5 years. The great and small saphenous veins had been removed to treat bilateral lower limb varices 30 years previously. Compression therapy and the application of an external preparation led to granulation. However, new punctate necrosis was observed in the granulation tissue. At the inferior floor, a calcified lesion was present beyond the ulcer and congestive skin lesion. It may have been primarily involved in a refractory condition. Extended extirpation of the ulcer, involving the calcified lesion, and congestive skin lesion, as well as soft skin tissue reconstruction, were performed. Healing was achieved. Histopathologically, ectopic ossification was suggested. Metaplasia related to phlebostasis-associated chronic inflammation may have been etiologically involved. The presence of bone may have caused a reduction in topical blood flow and secondary infection, delaying healing. Soft skin tissue reconstruction was effective.

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