Huda Najmul, Bhardwaj Shobhit, Abbas Mazhar, Asif Naiyer
Department of Orthopaedics, J.N. Medical College, Aligarh, India.
Acta Orthop Belg. 2007 Apr;73(2):279-81.
A rare, non-neoplastic lesion involving the 1st metatarsal bone in a 5-year-old female is described. Radiographically it presented as a cystic lesion of the whole of the metatarsal. Fine needle aspiration cytology showed it to be a benign giant cell lesion. The tumour was excised en bloc and the metatarsal replaced by a free fibular graft of adequate length. Histopathological examination confirmed the diagnosis as giant cell reaction of bone. The lesion is said to arise as a local tissue response to bleeding as evidenced by the clustering of giant cells in areas of haemorrhage. The entity should be differentiated from aneurismal bone cyst, brown tumours of hyperparathyroidism giant cell tumour, chondroblastoma, non-ossifying fibroma etc. Treatment usually consists of curettage or excision of the involved bone with or without bone grafting. Recurrences are common in curetted lesions.
描述了一名5岁女性累及第一跖骨的罕见非肿瘤性病变。影像学上表现为整个跖骨的囊性病变。细针穿刺细胞学检查显示为良性巨细胞病变。肿瘤整块切除，并用一段长度合适的游离腓骨移植替代跖骨。组织病理学检查确诊为骨巨细胞反应。据说该病变是作为对出血的局部组织反应而出现的，出血区域巨细胞的聚集证明了这一点。该实体应与动脉瘤样骨囊肿、甲状旁腺功能亢进的棕色瘤、巨细胞瘤、软骨母细胞瘤、非骨化性纤维瘤等相鉴别。治疗通常包括刮除或切除受累骨骼，可进行或不进行骨移植。刮除病变复发很常见。
