Lee Adam K, Woll Abbigail K, Malone W James J, Mirenda William M
Orthopedics. 2016 Sep 1;39(5):e1001-4. doi: 10.3928/01477447-20160616-09. Epub 2016 Jun 24.
Osteochondromas are benign lesions manifested as bony protrusions capped by cartilage. The exact cause of these growths is not known, and there is no treatment other than surgical excision if the lesion becomes symptomatic. Spontaneous resolution is an uncommon phenomenon that is not completely understood. A 12-year-old girl presented with a mass behind the left knee diagnosed as an osteochondroma. She was followed with serial radiographs because the lesion was minimally symptomatic. At 2.5 years after presentation, the patient reported feeling a "pop" with knee hyperflexion, and radiographic follow-up confirmed a decrease in the size of the growth. The protrusion continued to decrease in size until it was no longer detectable with radiographs, physical examination, and advanced imaging. Spontaneously resolving osteochondromas have been previously documented, but the literature is limited. There were just over 20 cases reported as of the writing of this article, and only 1 other case includes postresolution magnetic resonance imaging. This report of localized trauma inducing spontaneous resolution provides additional evidence and insight supporting previous theories on spontaneous resolution of osteochondromas, which may assist in counseling patients and their families regarding expected natural history. [Orthopedics.2016; 39(5):e1001-e1004.].
骨软骨瘤是一种良性病变,表现为有软骨覆盖的骨性突起。这些肿物的确切病因尚不清楚,若病变出现症状,除手术切除外没有其他治疗方法。自发消退是一种罕见现象,目前尚未完全了解。一名12岁女孩因左膝后方肿物就诊,诊断为骨软骨瘤。由于病变症状轻微,对其进行了系列X线片随访。就诊2.5年后,患者报告在膝关节极度屈曲时感到“啪”的一声,X线片随访证实肿物大小减小。突起继续缩小,直至X线片、体格检查及高级影像学检查均无法检测到。此前已有骨软骨瘤自发消退的文献记载,但数量有限。截至本文撰写时,报告的病例刚刚超过20例,且仅有1例其他病例包含消退后的磁共振成像。本例关于局部创伤导致自发消退的报告提供了更多证据和见解,支持了此前关于骨软骨瘤自发消退的理论,这可能有助于为患者及其家属提供有关预期自然病程的咨询。[《骨科学》.2016; 39(5):e1001-e1004.]