Ye Conglin, Luo Zhiping, Zeng Jin, Dai Min
Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Jiangxi Department of Orthopaedics, Shenzhen Hospital, Southern Medical University, Shenzhen City, China.
Medicine (Baltimore). 2017 Sep;96(37):e8049. doi: 10.1097/MD.0000000000008049.
Chondrosarcoma, characterized by the production of cartilage matrix, is a common bone tumor, accounting for 20% to 27% of all malignant bone tumors. It often occurs in the cartilage of the pelvis, femur, tibia, and humerus. However, chondrosarcoma of the patella is extremely rare.
The present study describes a case of chondrosarcoma affecting the right patella in a 68-year-old woman. The chief complaints were painful swelling and limitation of motion of the right knee for about half a year. The pain was a kind of dull ache. The skin around the right knee was red and hot. Moreover, she had a claudication gait due to the symptoms.
Irregular lytic lesions with ill-defined margins in the patella were determined through computed tomography and magnetic resonance imaging. The diagnosis of primary grade II chondrosarcoma was finally confirmed on the basis of postoperative pathological examination.
The patient underwent an open surgery named extensive resection of patellar tumor to remove the tumor tissue completely.
The patient was discharged without any complications 1 week after the surgery. At the 3-month follow-up, the patient was completely free from pain during daily activities, and normal range of motion of the right knee was achieved. Her gait was normal. There was no evidence of recurrence.
We believe that an extensive resection is suitable for treating chondrosarcoma to avoid as far as possible local recurrence. An awareness of the potential for chondrosarcoma to present in the patella is crucial for both orthopedic surgeons and radiologists when confronted with similar cases. Besides, as reports of chondrosarcoma of the patella are rare, this study adds a better understanding of this rare condition to the medical literature.
软骨肉瘤以产生软骨基质为特征，是一种常见的骨肿瘤，占所有恶性骨肿瘤的20%至27%。它常发生于骨盆、股骨、胫骨和肱骨的软骨部位。然而，髌骨软骨肉瘤极为罕见。
本研究描述了一名68岁女性右髌骨软骨肉瘤病例。主要症状为右膝关节疼痛性肿胀及活动受限约半年。疼痛为隐痛。右膝关节周围皮肤发红发热。此外，由于这些症状，她出现了跛行步态。
通过计算机断层扫描和磁共振成像确定髌骨内边界不清的不规则溶骨性病变。术后病理检查最终确诊为原发性二级软骨肉瘤。
患者接受了名为髌骨肿瘤广泛切除术的开放手术，以彻底切除肿瘤组织。
患者术后1周无任何并发症出院。在3个月的随访中，患者日常活动时完全无痛，右膝关节活动范围正常。步态正常。无复发迹象。
我们认为广泛切除适用于治疗软骨肉瘤，以尽可能避免局部复发。对于骨科医生和放射科医生而言，当面对类似病例时，认识到髌骨出现软骨肉瘤的可能性至关重要。此外，由于髌骨软骨肉瘤的报道罕见，本研究为医学文献增添了对这种罕见疾病的更好理解。
