Agarwal Gaurang, Kumar Raj, Dhanjani Bharat, Maini Lalit
Department of Orthopaedics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
Department of Orthopaedics, Asian Hospital, Faridabad, Haryana, India.
J Orthop Case Rep. 2020 May-Jun;10(3):67-70. doi: 10.13107/jocr.2020.v10.i03.1754.
Osteogenic sarcoma of patella is extremely rare and only few cases have been reported in the literature so far. Limb salvage, particularly reconstructing extensors of the knee, is a matter of debate in available literature. Henceforth, we would like to present this uncommon case of patellar osteosarcoma in a young female managed by chemotherapy and wide excision without extensor mechanism reconstruction.
A 25-year-old female had a history of painless swelling around the left knee for 6 months, which was progressively increasing in size. It was diagnosed as osteoblastic osteosarcoma patella radiologically, confirmed by open biopsy. The patient was managed by recommended protocol comprising neoadjuvant chemotherapy followed by tumor excision, thereafter chemotherapy in post-operative period. However, no reconstruction of the extensor mechanism was done. At 1-year follow-up, the patient was able to perform activities of daily living without any discomfort. She was able to ambulate unaided with no extensor lag.
For managing a case with osteosarcoma patella, chemotherapy along with optimal excision comprising total patellectomy without extensor mechanism reconstruction is a viable option.
髌骨骨肉瘤极为罕见,迄今为止文献中仅报道了少数病例。肢体挽救,尤其是重建膝关节伸肌,在现有文献中存在争议。在此,我们将呈现这例年轻女性髌骨骨肉瘤的罕见病例,该病例通过化疗及广泛切除进行治疗,未重建伸肌机制。
一名25岁女性,左膝周围无痛性肿胀6个月,且肿胀逐渐增大。经放射学检查诊断为成骨性髌骨骨肉瘤,开放活检予以证实。患者按照推荐方案进行治疗,包括新辅助化疗,随后进行肿瘤切除,术后继续化疗。然而,未对伸肌机制进行重建。在1年的随访中,患者能够毫无不适地进行日常生活活动。她能够独立行走,无伸肌滞后。
对于髌骨骨肉瘤病例的治疗,化疗以及包括未重建伸肌机制的全髌骨切除术在内的最佳切除是一种可行的选择。