Kim Whoan Jeang, Kim Kap Jung, Lee Sang Ki, Choy Won-Sik
Department of Orthopedic Surgery, Eulji University College of Medicine, Seo-gu, Daejeon, Republic of Korea.
Orthopedics. 2009 Dec;32(12):922. doi: 10.3928/01477447-20091020-25.
Osteochondroma is the most common benign bone tumor, accounting for more than one-third of all benign bone tumors. It usually develops at the metaphysis of the long bones, especially the distal femur and proximal tibia. Approximately 40% of osteochondromas are found around the knee. Osteochondroma commonly presents as a painless mass and is incidentally identified via plain radiographs. Thus, surgical excision is not routinely recommended unless the tumor causes clinical symptoms or cosmetic distress. Osteochondroma located in the pelvis is unusual. Spinal nerve root compressions due to pelvic osteochondroma are also rarely reported. We assessed the solitary pelvic osteochondroma of a 33-year-old man mimicking spinal disease. An exostotic bony projection composed of dense calcification of the cartilaginous cap arose from the iliac crest, which was located just lateral to the right sacroiliac joint in the paravertebral area, L5 level. Magnetic resonance imaging showed an irregular, exophytic outgrowing calcified mass with cartilage cap and exostotic mass compressed to the proximal part of the right L5 nerve root lateral to the nerve root foramen. The L5 nerve root was focally compressed and thinned.En bloc excision, the treatment of choice of symptomatic osteochondroma, was performed. The patient had complete resolution of symptoms postoperatively, and other neurologic symptoms may be expected to improve over time.
骨软骨瘤是最常见的良性骨肿瘤，占所有良性骨肿瘤的三分之一以上。它通常发生在长骨的干骺端，尤其是股骨远端和胫骨近端。约40%的骨软骨瘤发生在膝关节周围。骨软骨瘤通常表现为无痛性肿块，通过X线平片偶然发现。因此，除非肿瘤引起临床症状或影响美观，一般不建议常规手术切除。骨盆部位的骨软骨瘤较为少见。骨盆骨软骨瘤导致脊神经根受压的情况也鲜有报道。我们评估了一名33岁男性的孤立性骨盆骨软骨瘤，该肿瘤酷似脊柱疾病。一个由软骨帽致密钙化形成的外生骨突起自髂嵴长出，位于L5水平椎旁区域右骶髂关节外侧。磁共振成像显示一个不规则的、向外生长的钙化肿块，带有软骨帽，外生肿块压迫右侧L5神经根近端，位于神经根孔外侧。L5神经根局部受压且变细。对有症状的骨软骨瘤，首选的治疗方法是整块切除。术后患者症状完全缓解，预计其他神经症状也会随时间改善。
