Batheja Dheeraj, Sehgal Apoorv, Prasad Avijeet, Shahi Pratyush, Bansal Kuldeep
Orthopaedics, University College of Medicine Science and Guru Teg Bahadur Hospital, Delhi, IND.
Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND.
Cureus. 2020 Mar 30;12(3):e7467. doi: 10.7759/cureus.7467.
A 17-year-old female presented to us with pain and swelling in the right heel. Examination revealed the swelling to be tender, hard and fixed to the calcaneus. Radiographs showed an expansile, lytic lesion of the calcaneus with well-defined margins and no extraosseus spread. A core biopsy was done which showed multinucleated giant cells in a sea of mononuclear stromal cells, suggestive of a giant cell tumour (GCT). Curettage and filling up of the defect with bone cement was done under anaesthesia. The patient was fully ambulatory three months after the surgery. At two-year follow-up, the patient continued to be asymptomatic and radiographs revealed no signs of recurrence. It is important to note that GCT can occur in these rare sites and unusual age groups, and hence requires a good level of awareness of the surgeon and adequate preoperative workup, including biopsy, before proceeding to the definitive treatment of the lesion. Considering its potential local aggressiveness, early intervention is necessary. The patient should be kept under regular follow-up to detect any recurrence or metastasis in early stage.
一名17岁女性因右足跟疼痛和肿胀前来就诊。检查发现肿胀处压痛、质地硬且与跟骨相连。X线片显示跟骨有一个膨胀性溶骨性病变,边界清晰,无骨外扩散。进行了核心活检,结果显示在单核基质细胞海洋中有多核巨细胞,提示为骨巨细胞瘤(GCT)。在麻醉下进行了刮除术并用骨水泥填充缺损。术后三个月患者可完全行走。在两年的随访中,患者持续无症状,X线片未显示复发迹象。需要注意的是,骨巨细胞瘤可发生在这些罕见部位和不寻常的年龄组,因此外科医生需要有较高的认识水平,并在对病变进行确定性治疗之前进行充分的术前检查,包括活检。鉴于其潜在的局部侵袭性,早期干预是必要的。应定期对患者进行随访,以便早期发现任何复发或转移。