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人工关节假体旁假瘤患者复发性骨肉瘤的疑似病例

Suspicion of Recurrent Osteosarcoma in a Patient with Pseudotumour Adjacent To the Endoprosthesis.

作者信息

Duczkowski Marek, Duczkowska Agnieszka, Michalak Elżbieta, Tomasik-Kowalska Agnieszka, Szkudlińska-Pawlak Sylwia, Pachuta Bartosz, Raciborska Anna, Bekiesińska-Figatowska Monika

机构信息

Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw Poland.

Department of Pathomorphology, Institute of Mother and Child, Warsaw Poland.

出版信息

J Ultrason. 2022 Apr 27;22(89):140-143. doi: 10.15557/JoU.2022.0023. eCollection 2022 Apr.

Abstract

PURPOSE

Pseudotumor is a rare complication after arthroplasty, most often of the hip joint, in response to metal particles present in the implant. There are merely sporadic reports of pseudotumor in patients with bone sarcoma after sparing surgery with endoprosthesis implant. The aim of this study is to present the characteristic imaging features of pseudotumor.

CASE REPORT

We present a case of a 21-year-old male patient in whom a scheduled follow-up ultrasound revealed a painless lesion suspected of local recurrence at the border of the endoprosthesis and the bone stump 3.5 years after the end of treatment for osteosarcoma of the femur. Histopathology of the biopsy specimen revealed that the lesion was a pseudotumor.

CONCLUSIONS

Although pseudotumor is sporadic in patients treated with endoprosthesis for bone sarcoma, their prolonged survival could bear the risk of such a complication. Imaging studies, in particular ultrasound, may be helpful in differentiating from local recurrence of sarcoma, however, the histopathology of the specimen obtained by open biopsy at a reference center is crucial for the final diagnosis.

摘要

目的

假体周围假瘤是关节置换术后一种罕见的并发症,最常发生于髋关节,是对植入物中金属颗粒的反应。骨肉瘤患者在保留手术并植入假体后出现假瘤的报道仅有零星几例。本研究的目的是呈现假瘤的特征性影像学表现。

病例报告

我们报告一例21岁男性患者,在股骨骨肉瘤治疗结束3.5年后,定期随访超声检查发现假体与骨残端交界处有一个疑似局部复发的无痛性病变。活检标本的组织病理学检查显示该病变为假瘤。

结论

尽管骨肉瘤患者接受假体治疗后假瘤较为散在,但他们的长期生存可能会面临这种并发症的风险。影像学检查,尤其是超声检查,可能有助于与肉瘤的局部复发相鉴别,然而,在参考中心通过切开活检获取标本的组织病理学检查对于最终诊断至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fb8/9231517/bc67b6154abe/jou-22-140-g002.jpg

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