Fnini S, Labsaili N, Messoudi A, Largab A
Service de traumatologie-orthopédie, CHU Ibn-Rochd, Casablanca, Morocco.
Chir Main. 2008 Feb;27(1):54-7. doi: 10.1016/j.main.2007.10.007. Epub 2007 Nov 29.
Giant cell tumours (GCT) of bone are frequent, with variable behaviour, high risk of recurrence and an often benign histological appearance. Their location in the hand is uncommon, and there are few publications on the subject. Surgical treatment as described in the literature is very variable. We report a case of recurrent grade II GCT, arising in the proximal phalanx of the thumb, aggressive and causing a pathological fracture. After a surgical biopsy, we performed an "en bloc" resection of the first phalanx, with an iliac crest graft reconstruction and a double arthrodesis of the metacarpophalangeal and interphalangeal joint. No recurrence or lung metastasis was seen at 18 months follow-up.
骨巨细胞瘤(GCT)较为常见,其行为表现多样,复发风险高,组织学表现常为良性。该肿瘤在手的部位发病并不常见,关于这一主题的文献报道较少。文献中描述的手术治疗方法差异很大。我们报告一例复发性Ⅱ级GCT病例,发生于拇指近节指骨,具有侵袭性并导致病理性骨折。手术活检后,我们对第一掌骨进行了“整块”切除,采用髂嵴移植重建,并对掌指关节和指间关节进行了双关节融合术。随访18个月未见复发或肺转移。