Toepfer A, Diehl P, Gradinger R, Rudert M
Klinik für Orthopädie und Unfallchirurgie, Klinikum Rechts der Isar der Technischen Universität München.
Z Orthop Unfall. 2008 Sep-Oct;146(5):651-4. doi: 10.1055/s-2008-1038837. Epub 2008 Oct 9.
Haemophilic pseudotumour is a rare disease occurring in 1 % of patients with severe haemophilia as a long-term complication. Because both haemophilia A (factor VIII deficiency) and haemophilia B (factor IX deficiency) are X-linked recessive genetic disorders, pseudotumours are found almost exclusively in men between 20 and 70 years of age. Haemophilic pseudotumour has been defined as a progressive cystic swelling, produced by recurrent haemorrhage, which exerts increasing pressure on nearby structures. As a result, necrosis of skin, muscle and bone can be found. Neurovascular obstruction as well as pathologic fractures are severe complications of this disease. Most patients with pseudotumours are asymptomatic for a long time and many patients report sustaining an injury prior to the development of the tumour. Most haemophilic pseudotumours of the bone are located in the pelvis, femur and hand. We present the case of a 59-year-old male patient suffering from a haemophilic pseudotumour of the right distal femur. After verification of the diagnosis by means of an open biopsy, final surgery with curettage and plombage with bone cement was performed.
血友病性假肿瘤是一种罕见疾病,在1%的重度血友病患者中作为长期并发症出现。由于甲型血友病(因子VIII缺乏症)和乙型血友病(因子IX缺乏症)均为X连锁隐性遗传病,假肿瘤几乎仅见于20至70岁的男性。血友病性假肿瘤被定义为一种由反复出血产生的进行性囊性肿胀,对附近结构施加越来越大的压力。结果,可发现皮肤、肌肉和骨骼坏死。神经血管阻塞以及病理性骨折是该疾病的严重并发症。大多数患有假肿瘤的患者长期无症状,许多患者报告在肿瘤发生前受过伤。大多数骨血友病性假肿瘤位于骨盆、股骨和手部。我们报告一例59岁男性患者患有右股骨远端血友病性假肿瘤。通过开放活检确诊后,进行了刮除术并用骨水泥填充的最终手术。