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儿童潜在骨软骨瘤继发的滑囊滑膜软骨瘤病

Bursal Synovial Chondromatosis Secondary to Underlying Osteochondroma in a Child.

作者信息

Khandwala Kumail, Waheed Adeel A, Alvi Muhammad I, Mirza Waseem A, Umer Masood, Khurshid Eraj

机构信息

Department of Radiology, The Aga Khan University, Karachi.

Department of Orthopaedic Surgery, The Aga Khan University, Karachi.

出版信息

Cureus. 2017 Dec 14;9(12):e1944. doi: 10.7759/cureus.1944.

Abstract

Osteochondroma and synovial chondromatosis are frequently reported benign bony and cartilaginous lesions. Osteochondroma is distinguished by a cartilage-capped bony exostosis on the exterior surface of the bone, whereas synovial chondromatosis is secondary to metaplasia and is characterized by multiple cartilaginous loose bodies within the synovium. We present an atypical case of synovial chondromatosis developing in a bursa sec-ondary to an underlying osteochondroma of the proximal medial tibia in a child. It is extremely rare to see both these conditions occurring in one location simultaneously. Moreover, this association is an unusual occurrence in the pediatric age group. The patient underwent surgical excision of the lesions and the final diagnosis was confirmed on histology. Simulation to malignant degeneration is often observed and vigilant assessment of both lesions is essential to exclude the possibility of sarcomatous transformation in those who present with these conditions since clinical, radiological, and histopathological features may overlap. However, a proper preoperative distinction may prevent an unnecessary aggressive therapeutic approach, which stood true for our case.

摘要

骨软骨瘤和滑膜软骨瘤病是常见的良性骨与软骨病变。骨软骨瘤的特征是在骨的外表面有一个软骨帽覆盖的骨外生骨疣,而滑膜软骨瘤病继发于化生,其特征是滑膜内有多个软骨游离体。我们报告了一例儿童病例,在继发于近端内侧胫骨潜在骨软骨瘤的滑囊中发生了非典型滑膜软骨瘤病。在同一部位同时出现这两种情况极为罕见。此外,这种关联在儿童年龄组中也不常见。患者接受了病变的手术切除,最终诊断经组织学证实。常观察到类似恶性退变的情况,对这两种病变进行警惕性评估对于排除出现这些情况的患者发生肉瘤样转化的可能性至关重要,因为临床、放射学和组织病理学特征可能重叠。然而,术前进行恰当区分可避免不必要的激进治疗方法,我们的病例正是如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/502c/5812527/87e07da08907/cureus-0009-00000001944-i01.jpg

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