Vonderlind Hans Christoph, Jessel Matthias, Knobel Alexander, Juergensen Ingke, Struewer Johannes
Department of Orthopaedics and Traumatology, University Hospital Oldenburg, Germany.
Department of Orthopaedics and Traumatology, University Hospital Oldenburg, Germany.
Int J Surg Case Rep. 2020;69:83-86. doi: 10.1016/j.ijscr.2020.03.024. Epub 2020 Mar 28.
We report a case of late onset hyperplastic callus formation (HPC) in the right femur in type V osteogenesis imperfecta (OI) mimicking the occurrence of a malignant osteosarcoma.
A 27-year-old female patient consulted us due to swelling in her right femur over 2-3 months without trauma. X-rays looked like an osteosarcoma, blood tests showed increased bone metabolism. A CT scan, a MRI and biopsy were performed, showing late onset HPC due to osteogenesis imperfecta type V.
OI shows a heterogeneous disease pattern due to a variety of clinical and radiographic findings. HPC is a rare complication of OI type V. Differential diagnosis range from cortical or periosteal osteosarcoma, periostitis, myositis ossificans, subperiosteal hematoma secondary to trauma or osteomyelitis.
Recognition of HPC as a form of this particular type of OI is important to avoid misdiagnosis like malignant transformation to osteosarcoma. A biopsy and advanced imaging modalities like CT, MRI and scintigraphy are recommended.
我们报告一例V型成骨不全症(OI)患者右股骨出现迟发性增生性骨痂形成(HPC),类似骨肉瘤的发生。
一名27岁女性患者因右股骨肿胀2 - 3个月前来就诊,无外伤史。X线检查结果类似骨肉瘤,血液检查显示骨代谢增加。进行了CT扫描、MRI检查及活检,结果显示为V型成骨不全症导致的迟发性HPC。
由于多种临床和影像学表现,OI呈现出异质性疾病模式。HPC是V型OI的一种罕见并发症。鉴别诊断范围包括皮质或骨膜骨肉瘤、骨膜炎、骨化性肌炎、创伤继发的骨膜下血肿或骨髓炎。
认识到HPC是这种特殊类型OI的一种形式,对于避免误诊为骨肉瘤等恶性转化非常重要。建议进行活检以及采用CT、MRI和骨闪烁显像等先进的影像学检查方法。