McGrath Brian E, Schlatterer Daniel, Mindell Eugene R
Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo General Hospital, Buffalo, New York 14203, USA.
Clin Orthop Relat Res. 2006 Mar;444:250-5. doi: 10.1097/01.blo.0000205907.82221.1c.
Our patient presented with a rare lesion, a patella osteogenic sarcoma that spread to the anterior horn of the lateral meniscus via the arthroscope. He was treated arthroscopically for a torn medial meniscus of his right knee. A lesion in the patella was observed and a biopsy specimen was obtained through the arthroscope. The specimen was diagnosed as an osteogenic sarcoma. After 2 weeks of neoadjuvant chemo-therapy, the patient refused additional chemotherapy. Re-section of the knee and allograft arthrodesis were done 4 months after the initial arthroscopy. Pathologic examination of the resected specimen showed osteogenic sarcoma of the patella and a completely separate 1.0-cm nodule of osteogenic sarcoma tissue growing in the anterior horn of the lateral meniscus. The patient died 15 months after knee re-section with multiple pulmonary metastases. We are unaware that such an occurrence of an osteosarcoma spread through an arthroscope has been documented pathologically and reported.
我们的患者出现了一种罕见病变，即髌骨骨肉瘤，该肿瘤通过关节镜扩散至外侧半月板前角。他因右膝内侧半月板撕裂接受了关节镜治疗。术中观察到髌骨有一病变，并通过关节镜获取了活检标本。标本被诊断为骨肉瘤。新辅助化疗2周后，患者拒绝进一步化疗。初次关节镜检查4个月后进行了膝关节切除及同种异体骨融合术。切除标本的病理检查显示为髌骨骨肉瘤，且在外侧半月板前角有一个完全独立的1.0厘米骨肉瘤组织结节。患者在膝关节切除术后15个月死于多处肺转移。我们不知道这种骨肉瘤通过关节镜扩散的情况在病理上有记录并被报道过。
