Jørgensen Andrea René, Jørgensen Peter Holmberg, Jul Kiil Birgitte, Stilling Maiken
Orthopaedic Research Unit, Aarhus University Hospital, Aarhus N, Denmark
Department of Orthopedic Surgery, Aarhus Universitetshospital, Aarhus N, Region Midt, Denmark.
BMJ Case Rep. 2021 Mar 24;14(3):e236097. doi: 10.1136/bcr-2020-236097.
A 10-year-old boy presented with continuous reports of pain located to the left knee. Imaging revealed a sclerotic process in the left distal femur, and biopsies were consistent with chondroblastic osteosarcoma. As part of standard treatment the patient underwent neoadjuvant chemotherapy followed by limb sparring surgery and adjuvant chemotherapy. The entire tumour was excised and femoral bone reconstruction was performed with a double barrel free vascularised fibular graft. Bone mineral density (BMD) can be decreased in childhood survivors of cancer. The patient was followed for 7 years with dual-energy X-ray absorptiometry scans in order to assess BMD and graft adaption. Despite two accidental fractures to the graft region local and global BMD underwent an overall increase. Approximately 7 years after tumour resection the patient had a global Z-score of 0.2, which is considered within normal range.
一名10岁男孩持续诉说左膝疼痛。影像学检查显示左股骨远端有硬化过程，活检结果与软骨母细胞性骨肉瘤相符。作为标准治疗的一部分，患者接受了新辅助化疗，随后进行保肢手术和辅助化疗。整个肿瘤被切除，并用双筒游离带血管腓骨移植进行股骨重建。癌症儿童幸存者的骨矿物质密度（BMD）可能会降低。对该患者进行了7年的双能X线吸收测定扫描，以评估骨密度和移植骨的适应性。尽管移植区域发生了两次意外骨折，但局部和整体骨密度总体上仍有所增加。肿瘤切除约7年后，患者的整体Z评分为0.2，被认为在正常范围内。
