Tan Honglue, Yan Mengning, Yue Bing, Zeng Yiming, Wang You
Orthopedics. 2014 Jan;37(1):e87-91. doi: 10.3928/01477447-20131219-23.
Chondroblastoma of the patella is rare. Aneurysmal bone cysts, which develop from a prior lesion such as a chondroblastoma, are seldom seen in the patella. The authors report a case of a 36-year-old man who presented with 2 years of right knee pain without calor, erythema, pain on palpation, or abnormal range of motion. Radiological studies suggested aneurysmal bone cyst. The lesion was excised with curettage and the residual cavity filled with autogenous bone graft. Histopathology revealed chondroblastoma associated with a secondary aneurysmal bone cyst. In the follow-up period, the patient demonstrated normal joint activities with no pain. Normal configuration of the patella and bone union were shown on plain radiographs. The authors present a review of the literature of all cases of patellar chondroblastoma with aneurysmal bone cyst. This case is the 14th report of aneurysmal bone cyst arising in a chondroblastoma of the patella. According to the literature, computed tomography and magnetic resonance imaging are useful in the study of these lesions. The pathologic diagnosis is based on the presence of chondroblastoma and aneurysmal bone cyst. Treatment of this lesion includes patellectomy, curettage alone, and curettage with bone grafting. Despite the risk of recurrence of this lesion in the patella, the authors first recommend curettage followed by filling the cavity with bone graft. To protect the anterior tension of the patella intraoperatively, the bone window should be made at the medial edge of the patella to perform the curettage and bone grafting.
髌骨软骨母细胞瘤较为罕见。动脉瘤样骨囊肿多由先前的病变(如软骨母细胞瘤)发展而来,很少出现在髌骨中。作者报告了一例36岁男性,他右膝疼痛2年,无发热、红斑、触痛或活动范围异常。影像学检查提示为动脉瘤样骨囊肿。病变经刮除术切除,残留腔隙用自体骨移植填充。组织病理学显示软骨母细胞瘤合并继发性动脉瘤样骨囊肿。在随访期间,患者关节活动正常,无疼痛。X线平片显示髌骨形态正常且骨愈合良好。作者对所有髌骨软骨母细胞瘤合并动脉瘤样骨囊肿的病例进行了文献综述。该病例是第14例髌骨软骨母细胞瘤并发动脉瘤样骨囊肿的报告。根据文献,计算机断层扫描和磁共振成像对研究这些病变很有用。病理诊断基于软骨母细胞瘤和动脉瘤样骨囊肿的存在。该病变的治疗方法包括髌骨切除术、单纯刮除术以及刮除术加植骨术。尽管该病变在髌骨有复发风险,但作者首先推荐刮除术,然后用骨移植填充腔隙。为在术中保护髌骨的前侧张力,应在髌骨内侧边缘制作骨窗以进行刮除术和植骨术。