Taniguchi Yu, Kamada Hiroshi, Sugaya Hisashi, Nishino Tomofumi, Mishima Hajime, Ochiai Naoyuki, Yamazaki Masashi
Department of Orthopaedics Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
Case Rep Orthop. 2018 Jan 14;2018:5736341. doi: 10.1155/2018/5736341. eCollection 2018.
A subpubic cartilaginous cyst is a rare mass lesion derived from the pubic symphysis, which can cause acute or subacute urinary retention. We report a case of a subpubic cartilaginous cyst in a 62-year-old woman that caused lower abdominal pain and subacute urinary retention, requiring surgical resection. On physical examination, a hard, flexible, nontender mass, 4 cm in diameter, was palpable along the lower border of the pubic bone, extending to the perineum. Magnetic resonance imaging revealed a clearly distinct (3.8 cm × 3.8 cm × 7.2 cm) mass on the midpelvic side of the pelvis, centered on the pubic joint. We proceeded with en bloc resection of the mass, including a resection margin of 1 cm on either side. The bony defect was fixed with a locking plate. On pathological assessment, the mass was diagnosed as a subpubic cartilaginous cyst arising from the cartilage of the pubic symphysis. No tumor recurrence was identified over a 4-year follow-up. Based on our experience, we propose that en bloc resection of the mass, including a wider resection centered on the pubic symphysis, with internal fixation, is a possible treatment for a subpubic cartilaginous cystic mass lesion.
耻骨联合软骨囊肿是一种罕见的源于耻骨联合的肿块性病变,可导致急性或亚急性尿潴留。我们报告一例62岁女性的耻骨联合软骨囊肿病例,该囊肿引起下腹部疼痛和亚急性尿潴留,需要手术切除。体格检查时,在耻骨下缘可触及一个直径4厘米、质地硬、有弹性、无压痛的肿块,延伸至会阴。磁共振成像显示在骨盆中盆腔侧有一个边界清晰(3.8厘米×3.8厘米×7.2厘米)的肿块,以耻骨联合为中心。我们对肿块进行了整块切除,两侧各包括1厘米的切缘。骨缺损用锁定钢板固定。病理评估显示,该肿块被诊断为起源于耻骨联合软骨的耻骨联合软骨囊肿。在4年的随访中未发现肿瘤复发。根据我们的经验,我们建议对肿块进行整块切除,包括以耻骨联合为中心的更广泛切除,并进行内固定,这是耻骨联合软骨囊肿性肿块病变的一种可行治疗方法。