Sonnylal Laura, Peterson Joel R, Decilveo Alexander P, O'Connor Ian T, Wittig James C
John Theurer Cancer Center, Hackensack University Medical Center, 20 Prospect Avenue, Suite 501, Hackensack, NJ, 07601, USA.
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Skeletal Radiol. 2018 Oct;47(10):1443-1448. doi: 10.1007/s00256-018-2922-8. Epub 2018 Mar 10.
We report a rare case of giant periosteal osteoblastoma in the femur of a 21-year-old male. The patient presented with a painful, firm, non-tender mass in his left thigh. The pain was worse at night and was temporarily relieved with NSAIDS. He had no fevers, night sweats, or weight loss. The patient underwent preoperative radiological studies including plain radiographs, MRI, bone scan, and CT scan. An open biopsy was subsequently performed that was consistent with an aggressive, epithelioid osteoblastoma. Pathology demonstrated a neoplasm characterized by cohesive sheets of epithelioid osteoblasts, mixed with areas of conventional osteoblastoma displaying prominent osteoblastic rimming of woven bone trabeculae in a fibrovascular stroma. The patient subsequently underwent resection, cryosurgery, fixation, and bone grafting with cortical strut allografts. At final follow-up, 32 months postoperatively, there was no evidence of local recurrence. The patient had resumed all his normal activities. He could run without pain and had no restrictions with activities. The goal of this case report is to aid professionals in the diagnosis and treatment of highly uncommon aggressive osteoblastomas.
我们报告一例罕见的21岁男性股骨巨大骨膜成骨细胞瘤病例。患者左大腿出现一个疼痛、质地硬、无压痛的肿块。夜间疼痛加剧，服用非甾体抗炎药后可暂时缓解。他没有发热、盗汗或体重减轻。患者接受了术前影像学检查，包括X线平片、磁共振成像（MRI）、骨扫描和计算机断层扫描（CT）。随后进行了切开活检，结果与侵袭性上皮样成骨细胞瘤一致。病理显示肿瘤由成片的上皮样成骨细胞组成，伴有传统成骨细胞瘤区域，在纤维血管基质中可见编织骨小梁周围有明显的成骨细胞包绕。患者随后接受了切除、冷冻手术、固定以及用皮质支撑异体骨进行骨移植。术后32个月的最终随访显示，没有局部复发的迹象。患者已恢复所有正常活动。他可以无痛跑步，活动不受限。本病例报告的目的是帮助专业人员诊断和治疗极罕见的侵袭性成骨细胞瘤。
