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一名骨骼未成熟患者胫骨巨细胞瘤的罕见表现。

An Unusual Presentation of Giant Cell Tumor of the Tibia in a Skeletally Immature Patient.

作者信息

C Vijay, Nekkanti Supreeth, R RaviShankar, R ShashiKiran, R Sunila

机构信息

Department of Orthopaedics, JSS Medical College and Hospital, Mysore, Karnataka, India.

Department of Pathology, JSS Medical College and Hospital, Mysore, Karnataka, India.

出版信息

J Orthop Case Rep. 2018 May-Jun;8(3):10-13. doi: 10.13107/jocr.2250-0685.1086.

Abstract

INTRODUCTION

Giant cell tumors (GCTs) are locally aggressive tumors that principally affect the epiphysis of long bones. Histologically, these tumors consist of three types of cells: Osteoclast-like multinucleated giant cells, round mononuclear cells resembling mononucleocytes, and spindle-shaped round fibroblast-like stromal cells. Radiographically, the tumors appear osteolytic and radiolucent without a sclerotic border. The tumor rarely occurs in pediatric age group. Its incidence in pediatric patients varies from 1.8 to 7.5%.

CASE REPORT

A 15-year-old girl presented to us with the complaints of pain in the left knee of 3months' duration and inability to squat. Radiographic imaging was done which showed lytic lesion involving the proximal tibia and showing cortical destruction. The lesion was graded as a Campanacci Grade 3 tumor. The patient was taken up for surgery and an extended curettage was performed, and the cavity was packed with bone cement. The patient was asymptomatic at the end of 18-month follow-up and was continuing her normal daily activities.

CONCLUSION

GCT of the bone is extremely rare in skeletally immature patients. This particular case highlights the need for keeping the diagnosis of GCT at the periphery of one's vision when dealing with pediatric patients presenting with osteolytic lesion at the epimetaphysis of long bones.

摘要

引言

骨巨细胞瘤(GCTs)是具有局部侵袭性的肿瘤,主要累及长骨的骨骺。从组织学上看,这些肿瘤由三种类型的细胞组成:破骨细胞样多核巨细胞、类似单核细胞的圆形单核细胞以及梭形圆形成纤维细胞样基质细胞。在影像学上,肿瘤表现为溶骨性且呈透亮区,无硬化边界。该肿瘤在儿童年龄组中很少见。其在儿科患者中的发病率为1.8%至7.5%。

病例报告

一名15岁女孩因左膝疼痛3个月且无法下蹲前来就诊。进行了影像学检查,结果显示胫骨近端有溶骨性病变并伴有皮质破坏。该病变被分级为Campanacci 3级肿瘤。患者接受了手术,进行了扩大刮除术,并在空腔内填充了骨水泥。在18个月的随访结束时,患者无症状,继续进行正常的日常活动。

结论

骨巨细胞瘤在骨骼未成熟的患者中极为罕见。这个特殊病例凸显了在处理长骨干骺端出现溶骨性病变的儿科患者时,需要将骨巨细胞瘤的诊断纳入考虑范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df65/6298713/98d4e25303ff/JOCR-8-10-g001.jpg

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