Tungdim P Hegin, Singh I Ibomcha, Mukherjee Sagnik, Pertin Tobu
Department of Orthopaedics, Regional Institute of Medical Sciences, Imphal, Manipur, India.
J Orthop Case Rep. 2017 Jan-Feb;7(1):36-40. doi: 10.13107/jocr.2250-0685.678.
Osteochondroma is a benign bony lesion with cartilaginous cap occurring usually in long bones, but flat bones may also be involved, either isolated or as a part of a syndrome. Usually, they are asymptomatic, but appearance of symptoms such as mass effect may warrant surgical intervention, which is usually delayed till skeletal maturity.
A 4-year-old male child presented with swelling on ventral aspect of inferior angle of scapula associated with pain, pseudowinging of scapula, and snapping sound of the left shoulder on movement. Despite young age of the patient, the severity of the symptoms required immediate intervention. After preoperative workup and planning, the mass measuring 4 cm × 3 cm × 2.5 cm was resected completely, following which the patient was relieved of all the symptoms without any recurrence for the next 7-month follow-up. Histopathological examination confirmed the diagnosis of osteochondroma. Normally, as the growth usually stops after skeletal maturity, surgical intervention is delayed till that time. In our case, the symptoms were so debilitating that it required immediate surgical resection, following which the patient was symptom-free for the next 6 months and there were no clinical signs or symptoms of recurrence.
Excision of osteochondroma can be safely performed in a case, where it is debilitating, progressive, or unmanageable much before skeletal maturity with fair results.
骨软骨瘤是一种带有软骨帽的良性骨病变，通常发生于长骨，但扁骨也可能受累，可为孤立性或作为综合征的一部分。通常，它们无症状，但出现诸如肿块效应等症状时可能需要手术干预，而手术通常会推迟至骨骼成熟。
一名4岁男童因肩胛骨下角腹侧肿胀就诊，伴有疼痛、肩胛骨假性翼状肩胛及左肩部活动时的弹响。尽管患者年龄小，但症状的严重程度需要立即干预。经过术前检查和规划，完整切除了大小为4 cm×3 cm×2.5 cm的肿块，术后患者所有症状缓解，在接下来的7个月随访中无任何复发。组织病理学检查确诊为骨软骨瘤。通常，由于生长在骨骼成熟后通常会停止，手术干预会推迟至那时。在我们的病例中，症状非常严重，需要立即手术切除，术后患者在接下来的6个月无症状，且无复发的临床体征或症状。
在骨骼成熟前，若骨软骨瘤导致功能障碍、进行性发展或难以处理，可安全地进行切除，效果良好。
