Ukon Yuichiro, Tanaka Takaaki, Nagata Shigenori, Hagizawa Hiroki, Imura Yoshinori, Tamiya Hironari, Oshima Kazuya, Naka Norifumi, Aoki Yasuaki, Kuratsu Shigeyuki
Department of Orthopaedic Surgery, Belland General Hospital, Sakai, Osaka 599-8247, Japan.
Department of Orthopaedic Surgery, Osaka International Cancer Institute, Chuo-ku, Osaka 541-8567, Japan.
Oncol Lett. 2018 May;15(5):7909-7913. doi: 10.3892/ol.2018.8320. Epub 2018 Mar 22.
Calcific myonecrosis is a rare soft tissue condition. The first case was reported in 1960, however, the precise pathophysiology of calcific myonecrosis remains unclear. The disease was thought to arise from compartment syndrome within a confined space resulting in necrosis and fibrosis, subsequent repeated intralesional hemorrhage, mass enlargement and calcification. Several previous reports have described calcific myonecrosis, which include the formation of calcific myonecrosis after a prolonged period of post trauma. Notably, calcific myonecrosis has typically been described in the lower legs and characteristic imaging findings have been indicated. Furthermore, surgical intervention carries a high risk of complications. In the present case report 2 cases of calcific myonecrosis that occurred after a prolonged period of time following a traumatic event that impacted the lower leg were reported. CT images revealed disruption of calcified fascia and disease expansion into the outside of the fascia. Previous reports have implied that there is late focal enlargement of calcific myonecrosis following earlier enlargement, which may be caused by herniation through muscle fascia. However, no previous publications have focused on images for evidence of late local enlargement. To the best of our knowledge, this is the first report focusing on fascial herniation of calcific myonecrosis using images. Analysis of this feature using images may aid clinicians to differentiate calcific myonecrosis from malignancies.
钙化性肌坏死是一种罕见的软组织疾病。首例病例于1960年被报道，然而，钙化性肌坏死的确切病理生理学仍不清楚。该疾病被认为起因于有限空间内的骨筋膜室综合征，导致坏死和纤维化，随后反复的病灶内出血、肿块增大和钙化。此前有几篇报道描述过钙化性肌坏死，其中包括创伤后长时间形成的钙化性肌坏死。值得注意的是，钙化性肌坏死通常在小腿被描述，并且已经指出了其特征性的影像学表现。此外，手术干预具有较高的并发症风险。在本病例报告中，报道了2例在小腿受到创伤事件后很长一段时间发生的钙化性肌坏死病例。CT图像显示钙化筋膜中断，病变扩展至筋膜外。先前的报道暗示，钙化性肌坏死在早期增大后会出现晚期局灶性增大，这可能是由于通过肌肉筋膜的疝出所致。然而，以前没有出版物关注过晚期局部增大证据的图像。据我们所知，这是第一篇使用图像聚焦于钙化性肌坏死筋膜疝出的报告。利用图像对这一特征进行分析可能有助于临床医生将钙化性肌坏死与恶性肿瘤区分开来。
