Prabhu Jagadish, Nagaraj Veena, Mukhtar Iftikhar Ahmed
Department of Orthopedics, Bahrain Defence Force Hospital - Royal Medical Services, Riffa, Kingdom of Bahrain.
Department of Pathology, Bahrain Defence Force Hospital - Royal Medical Services, Riffa, Kingdom of Bahrain.
Open Orthop J. 2017 Jul 28;11:583-588. doi: 10.2174/1874325001711010583. eCollection 2017.
Juvenile psammomatoid ossifying fibroma (JPOF) is a rare fibro-osseous lesion that usually occurs in the facial bones. The pathognomonic histopathologic feature is the presence of spherical ossicles, which are similar to psammoma bodies. It is considered to be a unique lesion because of its reported tendency to occur in children and adolescents and its tendency for locally aggressive growth. Because this lesion is aggressive in nature with high recurrence rate, early detection and complete surgical excision are essential.
Herein, we present a case of 11 year old girl, who presented to our clinic with history of gradual onset pain around right elbow associated with limitation of right forearm rotation for 3 months. After getting informed consent, we performed needle biopsy and histopathologically it was diagnosed as Psammomatoid type juvenile ossifying fibroma (JPOF) of proximal radius. We performed extensive debridement, curettage of entire cystic lesion involving the proximal radius and filled the cavity with allograft bone granules and intramedullary titanium elastic nail through fibular strut graft, bridging the cystic lesion.
As far as our knowledge there is no reported case of psammomatoid type of juvenile ossifying fibroma of proximal radius. We believe that such tumors in long bones are aggressive and have tendency for recurrence. Definitive diagnosis is utmost important for proper planning, surgical excision and reconstruction of long bones and need regular follow up to look for any recurrence or malignant transformation.
青少年砂粒样骨化性纤维瘤(JPOF)是一种罕见的纤维骨性病变,通常发生于面骨。其特征性组织病理学表现为存在类似于砂粒体的球形骨小体。因其好发于儿童和青少年且具有局部侵袭性生长的倾向,被认为是一种独特的病变。由于该病变具有侵袭性且复发率高,早期发现和完整手术切除至关重要。
在此,我们报告一例11岁女孩,她因右肘周围逐渐出现疼痛并伴有右前臂旋转受限3个月前来我院就诊。在获得知情同意后,我们进行了针吸活检,组织病理学诊断为桡骨近端砂粒样型青少年骨化性纤维瘤(JPOF)。我们进行了广泛的清创,刮除了累及桡骨近端的整个囊性病变,并用同种异体骨颗粒填充骨腔,并通过腓骨支撑植骨置入髓内钛弹性钉,跨越囊性病变。
据我们所知,尚无桡骨近端砂粒样型青少年骨化性纤维瘤的病例报道。我们认为这种长骨肿瘤具有侵袭性且有复发倾向。明确诊断对于长骨的正确规划、手术切除和重建至关重要,并且需要定期随访以观察是否有复发或恶变。