Ilyas Muhammad Saad, Akram Rizwan, Zehra Uruj, Aziz Amer
Department of Orthopaedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore, Pakistan.
Department of Anatomy, University of Health Sciences, Lahore, Pakistan.
Foot Ankle Spec. 2024 Oct;17(5):510-514. doi: 10.1177/19386400221079487. Epub 2022 Mar 1.
An 18-year-old man presented with complaints of pain and swelling around the left ankle region. Local examination revealed diffuse, hard, mildly tender swelling with ill-defined margins over the medial aspect of the left ankle joint just below the medial malleolus. Radiographic and computed tomographic assessment revealed osteolytic lesion with moderately defined margins. Provisional diagnosis of Campanacci grade 2 giant cell tumor was made, which was later confirmed on histopathology. Extended intralesional curettage and reconstruction with polymethylmethacrylate cement was done under spinal anesthesia. Full weight bearing was allowed at 4 weeks when the below knee back slab was removed. Radiographic assessment was done every 3 months during the first year of follow-up and then every 6 months. No evidence of recurrence of tumor, collapse of talus, or avascular necrosis was found during follow-up. Managing such rare form of bone tumors with extended intralesional curettage and bone cement is an appropriate treatment and gives good functional results. Level V.
一名18岁男性因左踝关节周围疼痛和肿胀前来就诊。局部检查发现,在内踝下方的左踝关节内侧,有弥漫性、坚硬、轻度压痛的肿胀,边界不清。影像学和计算机断层扫描评估显示有边界中度清晰的溶骨性病变。初步诊断为坎帕纳奇2级骨巨细胞瘤,后经组织病理学证实。在脊髓麻醉下进行了扩大的病灶内刮除术并用聚甲基丙烯酸甲酯骨水泥重建。4周时拆除膝下支具后允许完全负重。随访的第一年每3个月进行一次影像学评估,之后每6个月进行一次。随访期间未发现肿瘤复发、距骨塌陷或缺血性坏死的迹象。采用扩大的病灶内刮除术和骨水泥治疗这种罕见的骨肿瘤是一种合适的治疗方法,且能取得良好的功能效果。V级。