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[足底纤维瘤病(莱德霍斯氏病)]

[Plantar fibromatosis (Ledderhose's disease)].

作者信息

Koudela K, Koudela K, Kunešová M, Koudelová J

机构信息

Klinika ortopedie a traumatologie pohybového ústrojí FN a LF UK Plzeň.

出版信息

Acta Chir Orthop Traumatol Cech. 2010 Aug;77(4):341-5.

Abstract

The authors describe the concomitant presence of plantar fibromatosis and Dupuytren's disease in a 33-year-old man. A lesion located under the sesamoid bones of the first metatarsophalangeal joint on the right showed an aggressive tendency (rapid growth, pain, impossibility to put weight on the medial side of the foot). Another lesion located proximal to the first one was smaller and painless. Neither plain radiography nor computed tomography showed any structural changes of the skeleton. Contrast-enhancement on magnetic resonance imaging revealed two lesions on the sole of the foot. Since a concurrence of plantar fibromatosis and malignant tumour could not be ruled out, an excision of both lesions and the adjacent plantar aponeurosis was made for biopsy examination. The operative procedure was carried out from two incisions.The intra-operative findings included proliferative growth and bleeding in the lesion located under the first metatarsophalangeal joint, and delimited growth without noticeable bleeding in the other lesion. Based on histological examination, the diagnosis of plantar fibromatosis was made for both lesions.The differential diagnosis and therapy of plantar fibromatosis is discussed.

摘要

作者描述了一名33岁男性同时患有足底纤维瘤病和掌腱膜挛缩症。右侧第一跖趾关节籽骨下方的一个病变显示出侵袭性倾向(生长迅速、疼痛、无法在足部内侧负重)。位于第一个病变近端的另一个病变较小且无痛。普通X线摄影和计算机断层扫描均未显示骨骼有任何结构变化。磁共振成像的对比增强显示足底有两个病变。由于不能排除足底纤维瘤病与恶性肿瘤并发的情况,遂对两个病变及相邻的足底腱膜进行切除以进行活检。手术操作通过两个切口进行。术中发现包括位于第一跖趾关节下方的病变有增生性生长和出血,而另一个病变为局限性生长且无明显出血。根据组织学检查,两个病变均诊断为足底纤维瘤病。文中讨论了足底纤维瘤病的鉴别诊断和治疗。

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