Downey Colum, Daly Aisling, Molloy Alan P, O'Daly Brendan J
Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin 9, Ireland.
Department of Medicine, Trinity College Dublin, Dublin 2, Ireland.
World J Orthop. 2020 Mar 18;11(3):197-205. doi: 10.5312/wjo.v11.i3.197.
Bone lesions can present the multi-displinary team with a challenge by way of diagnosis as some lesions share many radiological and histological characteristics. Giant cell tumours of the bone (GCTB) are relatively common, benign bone tumours. Aneurysmal bone cysts (ABC) are less common benign osteolytic lesions that are histologically similar to GCTBs but produce blood filled cavities. Both GCTBs and ABCs are locally aggressive and are typically found on meta-epiphyseal regions of long bones with pelvic tumours being less common.
A 17-year old female presented with atraumatic right groin pain and was initially diagnosed with a GCTB on the right superior pubic ramus of the pelvis. The patient was treated successfully with a wide excision, curettage and bone graft and underwent open reduction and internal fixation of the right hemi-pelvis. Following further intra-operative histological investigations, the lesion was diagnosed as an ABC.
This patient has had an uncomplicated post-operative course, has returned to comfortable weight bearing and will be reviewed for minimum 5 yr in the out-patient setting to monitor for reoccurrence.
骨病变给多学科团队的诊断带来了挑战，因为一些病变具有许多放射学和组织学特征。骨巨细胞瘤（GCTB）是相对常见的良性骨肿瘤。骨动脉瘤样囊肿（ABC）是较不常见的良性溶骨性病变，在组织学上与GCTB相似，但会产生充满血液的腔隙。GCTB和ABC均具有局部侵袭性，通常见于长骨的干骺端区域，盆腔肿瘤较少见。
一名17岁女性因无创伤性右腹股沟疼痛就诊，最初被诊断为骨盆右上耻骨支的GCTB。患者接受了广泛切除、刮除和骨移植治疗，并接受了右半骨盆切开复位内固定术。经过进一步的术中组织学检查，该病变被诊断为ABC。
该患者术后过程顺利，已恢复舒适的负重状态，将在门诊至少复查5年以监测复发情况。
