Morris Timothy Mark, Gamie Zakareya, Ghosh Kanishka Milton, Rankin Kenneth Samora
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Newcastle University, Newcastle upon Tyne, UK.
BMJ Case Rep. 2018 Feb 14;2018:bcr-2017-221275. doi: 10.1136/bcr-2017-221275.
Primary patellar neoplasms are rare, comprising 0.12% of primary bone tumours; thus, no standardised treatment related to staging exists. 70%-90% of primary patellar neoplasms are benign or intermediate with giant cell tumour (GCT) being the most common. GCTs are locally aggressive, have a high recurrence rate and metastasise in 1%-2%. We report the case of a 23-year-old man with histologically confirmed recurrent GCT of the patella to demonstrate that aggressive surgical management options described in the literature, such as patellectomy with or without complex reconstruction, may be excessive and cause patients undue morbidity. Initially, the patient underwent intralesional curettage with excellent recovery, but presented again with a local recurrence within a year. A further definitive operation was performed which included excision of the inferior pole followed by curettage of the patellar body and artificial bone grafting. The patient made a good recovery and at 5-year follow-up has maintained good function.
原发性髌骨肿瘤较为罕见,占原发性骨肿瘤的0.12%;因此,不存在与分期相关的标准化治疗方法。70%-90%的原发性髌骨肿瘤为良性或中间型,其中巨细胞瘤(GCT)最为常见。GCT具有局部侵袭性,复发率高,转移率为1%-2%。我们报告了一例23岁男性组织学确诊为复发性髌骨GCT的病例,以证明文献中描述的积极手术治疗方案,如有无复杂重建的髌骨切除术,可能过度且会给患者带来不必要的发病率。最初,患者接受了病灶内刮除术,恢复良好,但在一年内再次出现局部复发。随后进行了进一步的确定性手术,包括切除下极,随后刮除髌骨体并植入人工骨。患者恢复良好,在5年随访中保持了良好的功能。