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复发性青少年舟状骨巨细胞瘤:刮除术和植骨失败后行舟状骨切除及腕骨间融合术

Recurrent Adolescent Giant-Cell Tumor of the Scaphoid: Scaphoid Excision with Intracarpal Fusion after Failed Curettage and Bone Grafting.

作者信息

Hoedt Chris, Makar Gabriel S, Gutowski Christina J, Holdbrook Thomas, Kim Tae Won B, Fuller David A

机构信息

Cooper University Hospital, Department of Orthopaedic Surgery, 3 Cooper Plaza Suite 410, Camden, NJ 08103, USA.

Cooper Medical School of Rowan University, 401 Broadway Ave, Camden, NJ 08103, USA.

出版信息

Case Rep Orthop. 2019 Apr 9;2019:7571486. doi: 10.1155/2019/7571486. eCollection 2019.

Abstract

We present a case of the giant-cell tumor of bone in the scaphoid of a 17-year-old female. Imaging revealed an expansile lytic lesion of her scaphoid, and the diagnosis was confirmed with open biopsy. She was treated with curettage and iliac crest bone graft, in an effort to spare reconstruction of her wrist. After one year, she developed increasing tightness and pain. Local recurrence was apparent on radiographs, and CT revealed increased lucency with bony destruction in the area of prior excision. She was successfully treated, without recurrence to date, with complete scaphoid excision and a four-corner wrist fusion. Local recurrence of the giant-cell tumor of bone is high, especially in carpal bones. When treating patients with advanced lesions, more aggressive initial options should be considered.

摘要

我们报告一例17岁女性舟骨骨巨细胞瘤病例。影像学检查显示其舟骨有一膨胀性溶骨性病变,通过切开活检确诊。为避免进行腕关节重建,对她进行了刮除术和髂嵴骨移植治疗。一年后,她出现了日益加重的紧绷感和疼痛。X线片显示局部复发,CT显示先前切除部位透亮区增加且有骨质破坏。她接受了舟骨全切和四角腕关节融合术,治疗成功,至今未复发。骨巨细胞瘤的局部复发率很高,尤其是在腕骨。治疗晚期病变患者时,应考虑更积极的初始治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b369/6481125/7bfce1ad4d79/CRIOR2019-7571486.001.jpg

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