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[胫骨原发性包虫病。病例报告]

[Primary hydatid disease of the tibia. case report].

作者信息

Arancibia Agustin, Bürgesser Maria V, Albertini Ricardo A, de Diller Ana L, Villalba Carlos B

机构信息

Servicio de Patología, Hospital Privado de Córdoba SA, Córdoba Capital, Argentina.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2012 Mar;69(1):51-5.

Abstract

Hydatidosis is an endemic disease in different parts of the world. Its causal agent is the cestode from the genus Echinococcus. The most commonly affected organs in humans are liver and lung. Bone hydatid disease is a very rare entity, accounting for 0.5 to 4% of total cases. We report a case of a 58 year-old woman from La Rioja, Argentina, who consulted for left infapatellar pain and walking disability of eight months duration. Imaging studies showed a cystic lesion which involved metaphysis and diaphysis of left proximal tibia. Surgical resection was performed and histopathological study confirmed that it was a hydatid cyst. The patient did well and completed three cycles of treatment with albendazole. Currently, she has no evidence of disease and she recovered motility of her left leg. Primary hydatid bone disease, where there is no evidence of systemic disease, is even more unusual. Tibia involvement occurs in up to 15% of the cases. These lesions clinically manifest when they suffer any type of complications. Preoperative diagnosis is mainly made by imaging studies. Lesions are usually osteolytic and can involve cortical bone and extend to soft tissues. Differential diagnosis with inflammatory processes and bone tumors should is mandatory. Treatment is surgical and prognosis is poor due to its high morbi-mortality rate and recurrence risk from 70 to 80%.

摘要

包虫病是世界不同地区的一种地方病。其病原体是棘球绦虫属的绦虫。人类最常受影响的器官是肝脏和肺。骨包虫病是一种非常罕见的病症,占总病例的0.5%至4%。我们报告一例来自阿根廷拉里奥哈的58岁女性病例,她因左髌下疼痛和持续八个月的行走障碍前来就诊。影像学检查显示一个囊性病变,累及左胫骨近端的干骺端和骨干。进行了手术切除,组织病理学研究证实这是一个包虫囊肿。患者恢复良好,完成了三个周期的阿苯达唑治疗。目前,她没有疾病迹象,左腿恢复了活动能力。原发性骨包虫病,即没有全身疾病证据的情况,更为罕见。胫骨受累占病例的比例高达15%。这些病变在出现任何类型的并发症时才会有临床表现。术前诊断主要依靠影像学检查。病变通常为溶骨性,可累及皮质骨并延伸至软组织。必须与炎症性疾病和骨肿瘤进行鉴别诊断。治疗方法是手术,但由于其高病死亡率和70%至80%的复发风险,预后较差。

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