Wang Gang, Wen Xiaoyu, Qu Limei, Qi Xin, Yang Chen
Second Year Resident, Department of Orthopedic Surgery, The First Hospital of Jilin University, Changchun, China.
Attending Physician, Department of Hepatology, The First Hospital of Jilin University, Changchun, China.
J Foot Ankle Surg. 2016 Jan-Feb;55(1):201-6. doi: 10.1053/j.jfas.2015.07.002. Epub 2015 Sep 18.
We describe a rare case of intraosseous Schwannoma in the foot involving the tarsal navicular, cuboid, all 3 cuneiforms, and the second and third metatarsal bases in a 50-year-old female. Radiographs revealed a large, well-defined osteolytic lesion with endosteal scalloping and trabeculated contours at the margins. Intralesional excision, allograft bone implantation, and Kirschner wire fixation were performed. The histologic and immunohistochemical studies confirmed the diagnosis of Schwannoma. The distinctive radiographic features might have been the result of tumor spreading within the nutrient canals of the bones and direct compression of bone as the tumor enlarged. At the 18-month follow-up point, the patient had recovered well without recurrence. Intralesional excision produced a good functional outcome; however, extensive fusion surgery is recommended.
我们描述了一例罕见的足部骨内施万瘤病例，该病例发生在一名50岁女性身上，累及舟骨、骰骨、全部三块楔骨以及第二和第三跖骨基部。X线片显示一个大的、边界清晰的溶骨性病变，边缘有骨内膜扇贝样改变和小梁状轮廓。进行了病灶内切除、同种异体骨植入和克氏针固定。组织学和免疫组化研究证实了施万瘤的诊断。独特的影像学特征可能是肿瘤在骨滋养管内扩散以及随着肿瘤增大对骨直接压迫的结果。在18个月的随访时，患者恢复良好，无复发。病灶内切除产生了良好的功能结果；然而，建议进行广泛的融合手术。
