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多发性跟骨纤维发育不良:一例报告

Multiple calcaneal fibrous dysplasia: A case report.

作者信息

Ko Jong-Hyun, Park Gun-Joo, Lee Kwang-Bok

机构信息

Department of Orthopedic Surgery, Chonbuk National University Medical School, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea.

出版信息

Medicine (Baltimore). 2019 Dec;98(51):e18389. doi: 10.1097/MD.0000000000018389.

Abstract

RATIONALE

Fibrous dysplasia (FD) is a benign bone tumor due to developmental failure in the process of primitive bone remodeling to mature lamellar bone. The most common locations of monostotic FD of the extremity bones are the proximal femur, tibia, humerus and the radius. FD in the calcaneus is extremely rare and usually manifests clinically as a single bone lesion. Moreover, no research has reported on multiple lesions in calcaneal FD.

PATIENT CONCERNS

We report a 21-year-old man presented to our institution with pain upon walking for 2 months.

DIAGNOSES

We diagnosed the patient with multiple calcaneal FD through histologic examination of the excised biopsy that revealed cellular, spindly stroma and woven bone without osteoblastic rimming resembling Chinese characters INTERVENTIONS:: Plain X-ray, computed tomography, magnetic resonance imaging and histologic examination. An excisional biopsy with extended curettage and bone grafting with allogenous bone and autogenous bone marrow aspirate concentrate were performed.

OUTCOMES

No complications developed after surgery and during serial follow-ups at 3, 6 and 12 months. At a postoperative 12-month follow-up, a plain radiogram showed a well-consolidated bone graft in the lesions.

LESSONS

Calcaneal FD is rare disease entity. This case can help guide clinical decision-making in the future.

摘要

理论依据

骨纤维异常增殖症(FD)是一种由于原始骨重塑为成熟板层骨过程中的发育失败导致的良性骨肿瘤。四肢骨单发性FD最常见的部位是股骨近端、胫骨、肱骨和桡骨。跟骨FD极为罕见,通常临床上表现为单一骨病变。此外,尚无关于跟骨FD多发病变的研究报道。

患者情况

我们报告一名21岁男性,因行走疼痛2个月前来我院就诊。

诊断

通过对切除活检组织的组织学检查,我们诊断该患者为多发跟骨FD,检查显示细胞性、梭形基质和编织骨,无类似汉字的成骨细胞边缘。

干预措施

进行了X线平片、计算机断层扫描、磁共振成像和组织学检查。实施了扩大刮除术的切除活检以及同种异体骨和自体骨髓抽吸浓缩物的骨移植。

结果

术后及3、6和12个月的系列随访期间均未出现并发症。术后12个月随访时,X线平片显示病变处骨移植愈合良好。

经验教训

跟骨FD是一种罕见的疾病实体。该病例有助于指导未来的临床决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dce/6940136/cc903640ef8d/medi-98-e18389-g001.jpg

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