Goyal Pawan, Gautam Vishal, Saini Narender, Sharma Yogesh
Department of Orthopaedics, SMS Medical College, Jaipur, Rajasthan, India.
J Orthop Case Rep. 2016 Sep-Oct;6(4):27-30. doi: 10.13107/jocr.2250-0685.556.
Giant cell tumor (GCT) is a bone tumor involving epiphyseal area of bone abutting the subchondral bone. Commonly found in long bones such as proximal tibia and distal femur. We report a case of GCT of olecranon bone in a 23-year-old male.
A 23-year-old patient presented to our outpatient department with pain and mild swelling at the elbow from last 2 to 3 months. On examination, it was seen that there was a moderate swelling at the tip of the olecranon. The magnetic resonance imaging reported a lytic lesion in the olecranon but sparing the coronoid process of the ulna, the biopsy report confirmed that histologically it was a GCT of the bone. Total excision of the tumor was done after lifting the aponeurosis of the triceps muscle. The area remaining after excision of the tumor was phenol cauterized and cleaned with hydrogen peroxide solution. Triceps was reinserted on the remaining ulna. At follow-up the radiographs showed adequate excision of the tumor. The patient gained a full range of movement at the elbow and was functionally restored. There were no signs of any systemic spread of the tumor.
GCT though a very common bone tumor could be missed if present in atypical locations. Radiographically soap bubble appearance might not be present in every case, and there could be multiple diagnoses for lytic lesion in bone. Proper investigations and histopathological examination are necessary for accurate diagnosis and further treatment planning. Early treatment helps in complete excision of tumor along with return of adequate function of the patient.
骨巨细胞瘤(GCT)是一种累及骨骺区域并紧邻软骨下骨的骨肿瘤。常见于长骨,如胫骨近端和股骨远端。我们报告一例23岁男性鹰嘴骨骨巨细胞瘤病例。
一名23岁患者因肘部疼痛和轻度肿胀2至3个月前来我院门诊就诊。检查发现鹰嘴尖端有中度肿胀。磁共振成像报告显示鹰嘴有溶骨性病变,但尺骨冠突未受累,活检报告证实组织学上为骨巨细胞瘤。在提起肱三头肌腱膜后,将肿瘤完整切除。切除肿瘤后剩余的区域用苯酚烧灼并用过氧化氢溶液清洗。肱三头肌重新附着于剩余的尺骨上。随访时X线片显示肿瘤切除充分。患者肘部活动范围恢复正常,功能得以恢复。无肿瘤全身扩散的迹象。
骨巨细胞瘤虽是一种非常常见的骨肿瘤,但如果位于非典型部位可能会被漏诊。影像学上并非每个病例都会出现肥皂泡样表现,骨溶骨性病变可能有多种诊断。进行适当的检查和组织病理学检查对于准确诊断和进一步的治疗计划是必要的。早期治疗有助于完整切除肿瘤并使患者恢复适当功能。