Ngongang F O, Fodjeu G, Fon A C, Fonkoue L, Guifo M L, Bitang A Mafok L J, Ibrahima F
Department of Surgery and Specialties, Université des Montagnes, Bangangté, Cameroon; Yaoundé Emergency Center, Yaoundé, Cameroon.
Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
Int J Surg Case Rep. 2019;61:130-134. doi: 10.1016/j.ijscr.2019.07.015. Epub 2019 Jul 22.
Osteochondroma also known as exostosis is one of the most common benign bone tumours, and are characterized by bone protuberances surrounded by a cartilage layer. They generally affect the extremities of the long bones in an immature skeleton and deform them. They are easily diagnosed at the level of the appendicular skeleton. However, atypical localization and malignancy are sometimes challenging to diagnose on clinical evaluation and plain radiography. Therefore, more refine diagnostic tools may be required. Scapula localization of solitary exostosis is relatively rare.
We report the case of a 17 years old male patient reporting worsening shoulder pain since 3 years with right scapula winging. Computer tomography (CT) scan revealed an osteochondroma on the ventro-medial surface of the right scapula extending into the scapulo-thoracic space. Surgical excision was done and histopathological study confirmed osteochondroma of the scapula. We noted excellent post-operative pain alleviation after two weeks, full range of motion and a better self-esteem.
The scapula is involved in 3.0-6.4% of all cases. Osteochondroma usually arises on the anterior surface of the scapula. Surgical excision is an excellent treatment option for symptomatic patients with scapula osteochondroma. In our case presentation we used a muscle sparing technique. No muscle detachment will ensure rapid and better postoperative recovery. Surgical removal is useful in eliminating painful symptoms and avoids possible malignant transformation.
Good clinical outcome is expected with surgical excision of symptomatic scapula osteochondromas especially using muscle-sparing technique which offers a quick functional rehabilitation of patients.
骨软骨瘤也称为外生骨疣，是最常见的良性骨肿瘤之一，其特征是骨突起被软骨层包围。它们通常影响未成熟骨骼中长骨的末端并使其变形。它们在四肢骨骼水平很容易诊断。然而，非典型定位和恶性肿瘤有时在临床评估和平片上诊断具有挑战性。因此，可能需要更精确的诊断工具。孤立性外生骨疣的肩胛骨定位相对罕见。
我们报告了一例17岁男性患者，自3年前以来肩部疼痛加重，伴有右肩胛骨翼状畸形。计算机断层扫描（CT）显示右肩胛骨腹内侧表面有一个骨软骨瘤，延伸至肩胛胸壁间隙。进行了手术切除，组织病理学研究证实为肩胛骨骨软骨瘤。我们注意到术后两周疼痛明显缓解，活动范围完全恢复，自尊心增强。
肩胛骨受累占所有病例的3.0 - 6.4%。骨软骨瘤通常发生在肩胛骨的前表面。手术切除是有症状的肩胛骨骨软骨瘤患者的极佳治疗选择。在我们的病例报告中，我们采用了保留肌肉的技术。不进行肌肉分离可确保术后快速且更好地恢复。手术切除有助于消除疼痛症状并避免可能的恶性转化。
对于有症状的肩胛骨骨软骨瘤进行手术切除，尤其是采用保留肌肉的技术，有望获得良好的临床结果，该技术可为患者提供快速的功能康复。
