Smida M, Nigrou K, Sassi S, Ben Ghachem M
Service d'Orthopédie Infantile, Hôpital d'Enfants de Tunis, Bab Saadoun 1007 Tunis, Tunisie.
Acta Orthop Belg. 2002 Oct;68(4):403-7.
The authors report a rare case of juxtacortical osteosarcoma of the radius in a child. The diagnosis and treatment were delayed because of misleading and wrongly reassuring radiological and histological aspects. The 12-year-old boy was admitted for a tumefaction of the proximal extremity of the right radius noticed after trauma. Physical examination showed a hard and slightly painful swelling. Xrays showed an irregular osseous mass developed from the superior metaphysis of the radius and encircling it. MRI showed a juxtacortical tumor with medullary involvement. A biopsy concluded to a fracture callus. Ten months later, the tumor became painful and homogeneous, regular and well defined on Xrays. A repeat biopsy showed juxtacortical osteosarcoma. Enbloc resection of the tumor was done. After a follow-up of 2 years, the child is alive without recurrence and metastasis and with a satisfactory function of the upper limb.
作者报告了一例儿童桡骨皮质旁骨肉瘤的罕见病例。由于放射学和组织学方面的误导及错误诊断,导致诊断和治疗延误。这名12岁男孩因外伤后发现右桡骨近端肿胀入院。体格检查显示有一个坚硬且稍有压痛的肿块。X线显示一个从桡骨近端干骺端长出并环绕其的不规则骨质肿块。磁共振成像(MRI)显示为一个累及髓腔的皮质旁肿瘤。活检结果诊断为骨折骨痂。10个月后,肿瘤变得疼痛,在X线上呈均匀、规则且边界清晰的表现。再次活检显示为皮质旁骨肉瘤。遂对肿瘤进行了整块切除。经过2年的随访,患儿存活,无复发和转移,上肢功能良好。