Ansari Mohammed Tahir, Rastogi Shishir, Khan Shah Alam, Yadav Chandershekhar, Rijal Laxman
Assistant Professor of Orthopaedics, Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.
Professor, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
J Foot Ankle Surg. 2014 May-Jun;53(3):335-9. doi: 10.1053/j.jfas.2014.01.014. Epub 2014 Mar 20.
Schwannomas of osseous origin are rare, and schwannomas of the short tubular bones are even rarer. These benign-looking tumors are difficult to diagnose using imaging alone. However, histopathologic evaluation of a biopsy specimen can establish the diagnosis by identifying Antoni type A and B zones. Curettage and bone grafting will probably be adequate for treatment because malignant changes are unlikely. Large lesions can require en bloc excision and reconstruction. We describe what appears to be only the second case of a schwannoma in the first metatarsal of the foot in a 48-year-old woman. The lesion was poorly contained, with obvious breaks in the cortical shell. The diagnosis was confirmed by pathologic analysis. The lesion was successfully treated with en bloc resection and reconstruction with a nonvascularized fibular graft.
骨源性神经鞘瘤罕见，短管状骨的神经鞘瘤更为罕见。这些看似良性的肿瘤仅通过影像学检查很难诊断。然而，活检标本的组织病理学评估可通过识别Antoni A型和B型区域来确诊。刮除术和骨移植可能足以治疗，因为恶变的可能性不大。大的病变可能需要整块切除和重建。我们描述了一名48岁女性足部第一跖骨神经鞘瘤，这似乎是第二例此类病例。病变边界不清，皮质骨壳有明显破损。病理分析证实了诊断。通过整块切除并用非血管化腓骨移植重建成功治疗了该病变。
