Ma Xin-Nan, Qiang Shuai, Liu Tian-Yi, Cao Mei-Yu, Lv Song-Cen
Department of Orthopedics Department of Plastic Surgery Department of Pathology, Second Affiliated Hospital of Harbin Medical University Department of Pediatrics, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Medicine (Baltimore). 2017 Dec;96(48):e8962. doi: 10.1097/MD.0000000000008962.
Desmoplastic fibroma (DF) is a rare, locally invasive but benign bone tumor. It represents one of the rarest bone diseases, with an incidence of only 0.11% of all primary bone tumors.
Herein, a case of massive and unusual DF, with simultaneous involvement of ilium and ischium, is described. A 29-year-old man suffered minor pain in his right hip for 2 years. It worsened after sudden movements, which prevented him from walking normally. Physical examination showed a limitation when the right hip was flexed and a percussion pain on the hip region. A medical imaging examination showed that the right ilium and ischium had a massive bone lesion. The top of acetabular had very little bone left and a fracture was likely at any time. No prominent body weight loss was noted, because there was no extensive invasion to the adjacent soft tissue.
DF of the Ilium and Ischium.
The patient underwent a surgery involving curettage and grafting to maintain the stability of the pelvis.
The definitive pathological diagnosis was DF, without evidence of malignancy. The postoperative recovery course at 3-month follow-up was uneventful.
To the authors' knowledge, such a massive DF involving both ilium and ischium has been rarely reported. Young patients require appropriate and timely treatment modalities.
促结缔组织增生性纤维瘤(DF)是一种罕见的、局部侵袭性的良性骨肿瘤。它是最罕见的骨病之一,在所有原发性骨肿瘤中的发病率仅为0.11%。
在此,描述了一例巨大且不寻常的DF病例,同时累及髂骨和坐骨。一名29岁男性右髋部轻微疼痛2年。突然活动后疼痛加重,导致他无法正常行走。体格检查显示右髋部屈曲时受限,髋部区域有叩击痛。医学影像检查显示右髂骨和坐骨有巨大骨病变。髋臼顶部几乎没有骨质残留,随时可能发生骨折。未发现明显体重减轻,因为未广泛侵犯相邻软组织。
髂骨和坐骨DF。
患者接受了刮除术和植骨术以维持骨盆稳定性的手术。
最终病理诊断为DF,无恶性证据。3个月随访时术后恢复过程顺利。
据作者所知,如此巨大的同时累及髂骨和坐骨的DF很少见报道。年轻患者需要适当及时的治疗方式。