Tripathy Sujit K, Doki Sunil, Behera Gayatri, Sable Mukund
Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND.
Pathology, All India Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2019 Oct 1;11(10):e5819. doi: 10.7759/cureus.5819.
A 15-year-old girl presented with pain and swelling on the anterior aspect of the right knee for one year. The radiological evaluation with x-rays and magnetic resonance imaging suggested a benign aggressive lesion of the right patella with a cortical breach. Core needle biopsy of the lesion revealed it to be a giant cell tumor (GCT). She was treated with total patellectomy and end-to-end repair of quadriceps to the patellar tendon. The histopathological report of the whole specimen revealed it to be a GCT with secondary aneurysmal bone cyst (ABC). After 24 months, she was asymptomatic, and there was no evidence of local recurrence or distal metastasis. An extensive review of the literature revealed only four cases of combined GCT with secondary ABC in the patella. Though rare, GCT with secondary ABC of the patella should be kept as a differential diagnosis for anterior knee pain and swelling in young patients. The diagnosis is solely based on histopathological findings. It is imperative to obtain a precise tissue diagnosis in the preoperative period to plan appropriate treatment.
一名15岁女孩因右膝前部疼痛和肿胀就诊,症状已持续一年。X线和磁共振成像的影像学评估显示右髌骨有一个良性侵袭性病变,伴有皮质破坏。对该病变进行的粗针穿刺活检显示为骨巨细胞瘤(GCT)。她接受了全髌骨切除术,并将股四头肌与髌腱进行端端修复。整个标本的组织病理学报告显示为伴有继发性动脉瘤样骨囊肿(ABC)的骨巨细胞瘤。24个月后,她没有症状,也没有局部复发或远处转移的迹象。广泛的文献回顾显示,仅有4例髌骨合并继发性ABC的骨巨细胞瘤病例。虽然罕见,但髌骨继发性ABC的骨巨细胞瘤应作为年轻患者膝前疼痛和肿胀的鉴别诊断之一。诊断完全基于组织病理学检查结果。术前获得精确的组织诊断以规划适当的治疗至关重要。