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经切除和腕中关节融合术治疗的头状骨巨细胞瘤

Giant Cell Tumor of the Capitate Treated with Excision and Midcarpal Fusion.

作者信息

Oufkir Ayat Allah, Lazerges Cyril, Coulet Bertrand, Chammas Michel

机构信息

Hand and Upper Extremity Surgery Unit, Lapeyronie University Hospital, Montpellier, France.

Medical University of Fes, Sidi Mohamed Ben Abdellah University, CHU Hassan II, Fès, Morocco.

出版信息

J Wrist Surg. 2017 Aug;6(3):238-243. doi: 10.1055/s-0037-1598187. Epub 2017 Feb 7.

Abstract

Giant cell tumor (GCT) of bone is rare in the carpus, and only 11 cases have been reported in the capitate bone. The problem with this location is the high recurrence rate due to easy extension to the adjacent joint spaces and bones. We describe a case of GCT on the capitate bone and the treatment in comparison with the previously reported cases.  The case report concerns a 48-year-old woman with a GCT of the capitate diagnosed on curettage. The treatment consisted of large resection with the lunatum and third metacarpal arthrodesis, with a successful union at 2 years follow-up, no recurrence, and an improved function of the wrist.  When treated by curettage (alone or with adjuvant procedures), the GCT of the capitate recurred in four out of five cases. All tumors treated with large resection did not recur.  Recommended treatment of GCT of the capitate is resection with carpometacarpal arthrodesis.

摘要

骨巨细胞瘤(GCT)在腕骨中较为罕见,头状骨中仅报道过11例。该部位的问题在于肿瘤容易蔓延至相邻关节间隙和骨骼,导致复发率较高。我们描述了一例头状骨骨巨细胞瘤病例及其治疗方法,并与先前报道的病例进行比较。

该病例报告涉及一名48岁女性,经刮除术诊断为头状骨骨巨细胞瘤。治疗方法为对头状骨、月骨和第三掌骨进行大范围切除并实施关节融合术,随访2年时融合成功,无复发,腕关节功能改善。

采用刮除术(单独或辅助其他手术)治疗时,五例中有四例头状骨骨巨细胞瘤复发。所有接受大范围切除术的肿瘤均未复发。

推荐的头状骨骨巨细胞瘤治疗方法是切除并进行腕掌关节融合术。

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