Lykissas Marios G, Crawford Alvin H, Abruzzo Todd A
aDepartment of Pediatrics, Division of Orthopaedic Surgery bDepartment of Pediatrics, Division of Interventional Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
J Pediatr Orthop B. 2013 Nov;22(6):602-7. doi: 10.1097/BPB.0b013e32836379c2.
The purpose of this article is to present an unreported case of rib osteoblastoma associated with progressive adolescent idiopathic scoliosis and to discuss thoracogenic scoliosis as a potential cause of curve progression after tumor resection. An 11-year and 8-month-old girl with adolescent idiopathic scoliosis was referred with an incidental finding of an expansile lesion in the posterior left seventh rib. A computed tomography-guided needle biopsy established the diagnosis of benign osteoblastoma. Transarterial embolization was performed followed by wide resection. Sixteen months after surgery the patient underwent posterior spinal fusion to address her scoliosis progression during the growth spurt. Forty-one and 25 months after rib resection and spinal fusion, respectively, the patient remains asymptomatic, without local tumor recurrence, and with excellent correction of her spinal deformity. Although scoliosis secondary to rib osteoblastoma has been described in the literature, rib osteoblastoma may coexist with idiopathic scoliosis. In such a case, surgical management of osteoblastoma should not interfere with treatment of idiopathic scoliosis.
本文旨在介绍一例未报告的与青少年进行性特发性脊柱侧凸相关的肋骨骨母细胞瘤病例,并讨论胸廓源性脊柱侧凸作为肿瘤切除后曲线进展的潜在原因。一名11岁8个月大的青少年特发性脊柱侧凸女孩因偶然发现左第七后肋有一个膨胀性病变而前来就诊。计算机断层扫描引导下的针吸活检确诊为良性骨母细胞瘤。先进行了经动脉栓塞,随后进行了广泛切除。术后16个月,患者因生长突增期间脊柱侧凸进展接受了后路脊柱融合术。分别在肋骨切除和脊柱融合术后41个月和25个月,患者仍无症状,无局部肿瘤复发,脊柱畸形得到了良好矫正。虽然文献中已描述了继发于肋骨骨母细胞瘤的脊柱侧凸,但肋骨骨母细胞瘤可能与特发性脊柱侧凸共存。在这种情况下,骨母细胞瘤的手术治疗不应干扰特发性脊柱侧凸的治疗。