Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Ups J Med Sci. 2012 Aug;117(3):342-6. doi: 10.3109/03009734.2011.649865. Epub 2011 Dec 27.
We present a rare case of osteosarcoma involving the patella. A 30-year-old Japanese woman first consulted our out-patient clinic with a 2-year history of knee pain. Radiographs showed an enlargement of the patella with irregular distribution of both osteolytic and sclerotic lesions. Computed tomography and magnetic resonance imaging demonstrated soft tissue extension at the anterior part of the patella. Incisional biopsy showed abundant osteoid formation by spindle-shaped malignant cells, and the histological diagnosis was conventional osteosarcoma. The patient underwent preoperative chemotherapy, but there was no response. Furthermore, she developed a pathological fracture during chemotherapy. She underwent above-the-knee amputation with postoperative chemotherapy. She developed multiple metastases in the thoracic vertebrae 20 months after the surgery. At the most recent examination, she remains alive with multiple spinal metastases without paralysis 4 years after the surgery.
我们报告 1 例罕见的累及髌骨的骨肉瘤病例。1 名 30 岁的日本女性因膝关节疼痛就诊于我院门诊，病史 2 年。X 线片显示髌骨增大，同时存在溶骨性和成骨性病变的不规则分布。CT 和 MRI 显示髌骨前份软组织延伸。切开活检显示梭形恶性细胞有丰富的骨样组织形成，组织学诊断为常规骨肉瘤。患者接受了术前化疗，但无反应。此外，她在化疗期间发生病理性骨折。行膝上截肢术，术后化疗。术后 20 个月，她出现多发胸椎转移。在最近一次检查时，她在术后 4 年仍存活，伴有多发脊柱转移但无瘫痪。
