de Moraes Frederico Barra, de Melo Mariana Christino, Rocha Allan Vieira, Dos Santos Mauro Rodrigues
Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Rev Bras Ortop. 2014 Mar 22;49(2):206-9. doi: 10.1016/j.rboe.2014.03.008. eCollection 2014 Mar-Apr.
The aim was to report on a rare case of patellar osteochondroma. A 60-year-old man presented a tumor on his left patella that had developed over a 10-year period, which is a rare occurrence, considering the patient's age and the site at which the tumor appeared. The clinical condition comprised mild pain and the presence of a mass, without limitation of flexion-extension or any neurovascular deficit. The tumor dimensions were 8 cm longitudinally × 6 cm transversally × 3 cm anteroposteriorly. It was hardened and was adhering to the patellar bone plane. On radiographs and tomographic scans, we observed areas of greater density corresponding to bone and other less dense areas that could correspond to slow-growing cartilage, with irregularities on the patellofemoral joint surface. Simple resection of the tumor was performed, and the anatomopathological examination confirmed that it was a patellar osteochondroma. Osteochondroma, or osteocartilaginous exostosis, includes a large proportion of the benign bone tumors. It results from cell alterations that trigger unregulated production of spongy bone. It is basically treated by means of surgical removal of the tumor mass. This is not essential, but is recommended in order to avoid lesions caused by contiguity and the risk of malignant transformation.
目的是报告一例罕见的髌骨骨软骨瘤病例。一名60岁男性,其左髌骨上出现一个肿瘤,该肿瘤在10年期间逐渐形成,考虑到患者年龄及肿瘤出现的部位,这种情况较为罕见。临床症状包括轻度疼痛和肿块,屈伸不受限,也无任何神经血管缺损。肿瘤尺寸为纵向8厘米×横向6厘米×前后径3厘米。肿瘤质地坚硬,附着于髌骨骨面。在X线片和断层扫描中,我们观察到对应于骨质的密度较高区域以及其他可能对应于生长缓慢的软骨的密度较低区域,髌股关节表面不平整。对肿瘤进行了单纯切除,解剖病理学检查证实为髌骨骨软骨瘤。骨软骨瘤,即骨软骨性外生骨疣,占良性骨肿瘤的很大比例。它是由细胞改变引发海绵状骨的无节制生成所致。基本上通过手术切除肿瘤块进行治疗。这并非必需,但为避免邻近部位病变及恶性转化风险,建议进行手术。