INCIDENTALLY DISCOVERED PULMONARY NEOPLASIA IN A PATIENT WITH POSTTRAUMATIC AVULSION OF CALCANEAL REGION - A BLESSING IN DISGUISE

Abstract

In the last century, foot and ankle related traumatic pathology became more and more frequent. A 75 years old male with associated peripheral arterial disease presented himself in ER with an infected, contusive wound at the left foot sole and calcaneum. After local treatment (debridement, hyaluronic acid derivatives and antibiotics), the wound evolution was good. During the extensive clinical and paraclinical investigations preceding cardiovascular surgery for the pre-existing peripheral arteriopathy), a pulmonary tumor in resectable stage was discovered. So, the patient underwent pulmonary bilobectomy and afterward a cutaneous free groin flap reconstruction of the foot. The local wound evolution was good, and the patient could stand and walk after a month. He is currently under oncological supervision. Although skin grafts are recommended in lesions affecting weightbearing zones, in this case, given the arteriopathy, it was preferred a free skin flap. In this case with complicated, intricated pathology, the traumatic episode played also a beneficial role by helping the early diagnosis of an operable lung cancer.

Keywords

• posttraumatic avulsion, calcaneum, lung cancer, free skin flap