Creissen Adam, Rajeev Aysha, Jain Kumud, Banaszkiewicz Paul
Orthopaedic Department, Queen Elizabeth Hospital, Gateshead, United Kingdom.
Clinical Pathology, Queen Elizabeth Hospital, Gateshead, United Kingdom.
Case Rep Oncol. 2020 Apr 21;13(1):436-441. doi: 10.1159/000506451. eCollection 2020 Jan-Apr.
Traumatic avulsion fractures of the lesser trochanter are usually seen along with fractures of the proximal femur and with young adolescents involved in high-intensity sporting injuries. Atraumatic isolated lesser trochanter avulsion in adults are most commonly associated with malignancy. We describe a case of a female in her sixties who was previously fit and healthy with no systemic illness and no history of trauma presenting with groin pain. The X-ray demonstrated an isolated lesser trochanter avulsion fracture. Further imaging including MRI and a staging CT scan of the neck, chest, abdomen and pelvis revealed a pulmonary tumour. Biopsy later confirmed this as a non-small cell carcinoma of the lung. At the time of publication, she had been started on palliative chemotherapy (afatinib) with encouraging results.
小转子创伤性撕脱骨折通常与股骨近端骨折同时出现，多见于参与高强度运动损伤的青少年。成人非创伤性孤立性小转子撕脱最常见于恶性肿瘤。我们报告一例60多岁女性病例，她既往身体健康，无全身性疾病，无外伤史，现因腹股沟疼痛就诊。X线显示孤立性小转子撕脱骨折。进一步的影像学检查，包括MRI以及颈部、胸部、腹部和骨盆的分期CT扫描，发现肺部有肿瘤。活检后来证实为肺非小细胞癌。在发表本文时，她已开始接受姑息化疗（阿法替尼），效果令人鼓舞。
