Rosario Mamer S, Yamamoto Norio, Hayashi Katsuhiro, Takeuchi Akihiko, Kimura Hiroaki, Miwa Shinji, Higuchi Takashi, Inatani Hiroyuki, Abe Kensaku, Taniguchi Yuta, Aiba Hisaki, Tsuchiya Hiroyuki
Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan.
Department of Orthopaedics, East Avenue Medical Center, East Avenue, Diliman, 1101, Quezon City, Metro Manila, Philippines.
World J Surg Oncol. 2017 May 15;15(1):102. doi: 10.1186/s12957-017-1166-8.
Simple bone cysts (SBC) have been documented to occur in adults with closed physeal plates, most commonly affecting the calcaneus in this patient subset. Although most authors theorize an association to trauma, etiology of simple bone cysts remains an enigma up to now.
A 26-year-old kickboxing coach sought consult for a painful right shoulder which on radiographs and magnetic resonance (MR) imaging showed a proximal humeral lesion with signs of ossification. The patient was lost to follow-up but again sought consult after 3 years for the recurring complaint. On repeat radiographs, computed tomography (CT) scan, and MR images, tumor enlargement with cystic findings typical of simple bone cyst were documented. Diagnostic aspiration of the lesion was firstly done, revealing straw-colored fluid. The patient then underwent intralesional curettage with alpha-tricalcium phosphate cement reconstruction of the lytic defect. No perioperative complications were incurred, and on latest follow-up at 3 years postoperatively, Musculoskeletal Tumor Society (MSTS) and visual analog scale (VAS) pain scores were 30/30 and 0/10, respectively.
The authors believe their report provides support to a possible association to trauma of simple bone cysts occurring in the adult population with closed physes and suggest this subset of patients may require a different treatment approach from that for juvenile simple bone cysts.
已有文献记载，单纯性骨囊肿（SBC）可发生于骨骺板闭合的成年人，在该患者亚组中最常累及跟骨。尽管大多数作者推测其与创伤有关，但单纯性骨囊肿的病因至今仍是个谜。
一名26岁的跆拳道教练因右肩疼痛前来咨询，X线片和磁共振成像（MR）显示肱骨近端有一个伴有骨化迹象的病变。该患者失访，但3年后因同样的复发性症状再次前来咨询。复查X线片、计算机断层扫描（CT）和MR图像，记录到肿瘤增大并伴有单纯性骨囊肿典型的囊性表现。首先对病变进行诊断性穿刺抽吸，抽出草黄色液体。然后患者接受了病灶内刮除术，并用α-磷酸三钙骨水泥重建溶骨性缺损。未发生围手术期并发症，术后3年的最新随访中，肌肉骨骼肿瘤学会（MSTS）和视觉模拟量表（VAS）疼痛评分分别为30/30和0/10。
作者认为他们的报告支持了在骨骺闭合的成年人群中发生的单纯性骨囊肿可能与创伤有关的观点，并建议这一患者亚组可能需要与青少年单纯性骨囊肿不同的治疗方法。
