Ramírez-González Manuel A, Olivella Gerardo, Ramírez Norman, Soler-Salas Antonio, Astacio Eric, Bibiloni Juan, Foy-Parilla Christian
Orthopaedic Surgery Department, University of Puerto Rico, Medical Sciences Campus, San Juan, 00936-5067, Puerto Rico.
Pediatric Orthopaedic Surgery Department, Mayagüez Medical Center, Mayagüez, Puerto Rico.
Int J Surg Case Rep. 2020;77:560-564. doi: 10.1016/j.ijscr.2020.11.112. Epub 2020 Nov 23.
Giant cell tumor of bone (GCTB) in skeletally immature (SI) patients are rare benign lesions that have locally aggressive growth pattern and high risk of recurrence. The presence of GCTB at the proximal epiphysis of humerus in SI patients has never been described in literature.
This report shows the case of a 10-year-old SI male who presented with a GCTB at the proximal epiphysis of humerus that was treated with curettage, cement and adjuvant therapy.
The presence of a lytic growing lesion at the proximal humerus in a SI patient should alert clinicians to consider GCTB in their differential diagnosis. The management of GCTB in SI patients is challenging for orthopaedic surgeons. Tumor resection with cementation and adjuvant therapy has been described as a method rationale to prevent the recurrence and preserve the joint function in SI patients with GCTB at the proximal epiphysis of humerus. Clinicians should continue to monitor these patients with radiographic imaging for possible recurrence, metastasis or growth plate injury.
Tumor resection with cementation and adjuvant therapy offers a treatment alternative to prevent the recurrence and preserve the joint function in SI patients with GCTB at the proximal epiphysis of humerus. The use of a prothesis in a SI patient should avoided if possible, to prevent implant-related complications and damage to the growth plate.
骨骼未成熟(SI)患者的骨巨细胞瘤(GCTB)是罕见的良性病变,具有局部侵袭性生长模式和高复发风险。文献中从未描述过SI患者肱骨近端骨骺出现GCTB的情况。
本报告展示了一名10岁SI男性的病例,该患者肱骨近端骨骺出现GCTB,接受了刮除、骨水泥填充及辅助治疗。
SI患者肱骨近端出现溶骨性生长病变应提醒临床医生在鉴别诊断时考虑GCTB。对于骨科医生而言,SI患者GCTB的治疗具有挑战性。肿瘤切除联合骨水泥填充及辅助治疗已被描述为预防肱骨近端骨骺GCTB的SI患者复发并保留关节功能的一种合理方法。临床医生应继续通过影像学检查监测这些患者,以发现可能的复发、转移或生长板损伤。
肿瘤切除联合骨水泥填充及辅助治疗为预防肱骨近端骨骺GCTB的SI患者复发并保留关节功能提供了一种治疗选择。对于SI患者,应尽可能避免使用假体,以防止植入相关并发症和生长板损伤。