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儿童胫骨骨化性罗萨伊-多夫曼病:一例报告

Osseous Rosai-Dorfman disease of tibia in children: A case report.

作者信息

Vithran Djandan Tadum Arthur, Wang Jian-Zhou, Xiang Feng, Wen Jie, Xiao Sheng, Tang Wen-Zhong, Chen Qian

机构信息

Department of Pediatric Orthopedic, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha 410013, Hunan Province, China.

出版信息

World J Clin Cases. 2021 Feb 26;9(6):1416-1423. doi: 10.12998/wjcc.v9.i6.1416.

Abstract

BACKGROUND

Rosai-Dorfman disease (RDD), or sinus histiocytosis with massive lymphadenopathy, is a benign histiocytic disorder. Extranodal involvement is common, occurring in > 40% of patients, but bone involvement occurs in < 10% of cases. In addition, primary bone RDD is extremely rare. The majority of patients are adolescents and young adults, and the mean age at onset is 20-years-old.

CASE SUMMARY

We report an 8-year-old Chinese girl who presented to our hospital with an insidious onset of swelling and pain in the middle shaft of her right tibia for 4 mo. We performed total surgical resection of the right tibia lesion and allograft transplantation. A good prognosis was confirmed at the 6 mo follow-up. Pain and swelling symptoms were totally relieved, range of motion of her right knee and ankle returned to normal, and there was no clinical evidence of lesion recurrence at last follow up. Our case is the second reported case of osseous RDD without lymphadenopathy in the shaft of the tibia of a child.

CONCLUSION

Extranodal RDD is a rare disease and can be misdiagnosed easily. Lesion resection and allograft transplantation are an option to treat extranodal RDD in children with good short term result. Pediatric orthopedist should be aware of this rare disease, especially extranodal involvement.

摘要

背景

罗萨伊-多夫曼病(RDD),即伴巨大淋巴结病的窦性组织细胞增生症,是一种良性组织细胞疾病。结外受累很常见,超过40%的患者会出现,但骨受累病例不到10%。此外,原发性骨RDD极为罕见。大多数患者为青少年和青年成年人,平均发病年龄为20岁。

病例摘要

我们报告一名8岁中国女孩,因右胫骨中段隐匿性肿胀和疼痛4个月前来我院就诊。我们对右胫骨病变进行了手术全切及同种异体移植。6个月随访时证实预后良好。疼痛和肿胀症状完全缓解,右膝和踝关节活动范围恢复正常,最后一次随访时无病变复发的临床证据。我们的病例是第二例报道的儿童胫骨骨干无淋巴结病的骨RDD病例。

结论

结外RDD是一种罕见疾病,容易误诊。病变切除及同种异体移植是治疗儿童结外RDD的一种选择,短期效果良好。小儿骨科医生应了解这种罕见疾病,尤其是结外受累情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c5/7896673/6cb8c382b13c/WJCC-9-1416-g001.jpg

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