Saad A, Hanif U, Evans S, Iqbal A, Davies M, James S, Botchu R
Department of Orthopaedics, Royal Orthopaedic Hospital, Birmingham, UK.
Department of Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham, UK.
J Clin Orthop Trauma. 2019 Nov-Dec;10(6):1046-1049. doi: 10.1016/j.jcot.2019.07.001. Epub 2019 Jul 10.
Primary bone tumours arising from the lesser trochanter (LT) are rare and the literature describing them is sparse. In this paper, we describe the largest series of LT tumours describing the demographics, diagnosis and management.
A retrospective search of prospectively maintained radiology and oncology databases was performed to identify bone tumours of the LT diagnosed between 2007 and 2018. Metastatic lesions were excluded. All cases were re-reviewed by a senior Radiologist and all case of isolated tumours of the LT were included.
23 cases of isolated LT tumours were identified. There were 15 males and 8 females. Mean age of our cohort was 32 (14-63) years. Most (n = 19, 82.6%) cases had classic radiological (Radiographic, MR Imaging and CT) features and therefore did not undergo biopsy. 4 patients had equivocal radiological investigations that required biopsy to confirm the diagnosis. MR imaging was the most commonly used imaging modality for diagnosis (n = 17, 73.9%)There was a broad range of tumour subtypes, and osteochondroma (n = 17, 73.9%) the most frequently diagnosed. Surgical excision was performed in 4 patients (all osteochondromas) and 4 patients underwent therapeutic radiological guided hip injections for symptomatic relief. The remaining cases were managed conservatively and where they were identified incidentally, no intervention was required.
We report the largest case series of isolated primary bone tumours of the LT. All isolated primary bone tumours of LT are benign. Osteochondroma is the most common. The diagnosis can be made with on radiological investigations in most patients.
起源于小转子(LT)的原发性骨肿瘤罕见,相关文献描述较少。在本文中,我们描述了关于LT肿瘤的最大系列病例,涵盖了人口统计学、诊断和治疗情况。
对前瞻性维护的放射学和肿瘤学数据库进行回顾性检索,以确定2007年至2018年间诊断的LT骨肿瘤。排除转移性病变。所有病例均由一名资深放射科医生重新审查,纳入所有孤立性LT肿瘤病例。
共识别出23例孤立性LT肿瘤病例。其中男性15例,女性8例。我们研究队列的平均年龄为32岁(14 - 63岁)。大多数病例(n = 19,82.6%)具有典型的放射学(X线、磁共振成像和CT)特征,因此未进行活检。4例患者的放射学检查结果不明确,需要活检以确诊。磁共振成像(MRI)是最常用的诊断成像方式(n = 17,73.9%)。肿瘤亚型种类繁多,骨软骨瘤最常见(n = 17,73.9%)。4例患者(均为骨软骨瘤)接受了手术切除,4例患者接受了放射引导下的髋关节治疗性注射以缓解症状。其余病例采取保守治疗,对于偶然发现的病例,无需干预。
我们报告了最大系列的孤立性LT原发性骨肿瘤病例。所有孤立性LT原发性骨肿瘤均为良性。骨软骨瘤最为常见。大多数患者通过放射学检查即可确诊。