Chaudhary Sumedh D, Agrawal Pravin S, Sakharkar Nilesh S
Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India.
J Orthop Case Rep. 2022 Sep;12(9):92-94. doi: 10.13107/jocr.2022.v12.i09.3332.
Giant cell tumor of bone most commonly involves ends of the long bones in a skeletally mature patient. Giant cell tumor of the bones of the hand and feet is very rare, so is the giant cell tumor of talus.
We are reporting a case of giant cell tumor of talus in a 17-year-old female who presented with a history of pain and swelling around left ankle since 10 months. Radiographs of the ankle showed lytic expansile lesion involving whole of talus. Talectomy followed by calcaneo-tibial fusion was done as intralesional curettage was not feasible in this patient. Histopathology confirmed the diagnosis of giant cell tumor. There was no evidence of recurrence even at 9 years follow-up and the patient was able to carry out her daily activities without much discomfort.
Giant cell tumor is most commonly encountered around the knee or distal radius. Involvement of foot bones especially talus is extremely uncommon. In early presentation, extended intralesional curettage with bone grafting and, in late, talectomy with tibiocalcaneal fusion are the treatment options.
骨巨细胞瘤最常累及骨骼成熟患者的长骨末端。手足骨的骨巨细胞瘤非常罕见,距骨的骨巨细胞瘤亦是如此。
我们报告一例17岁女性距骨骨巨细胞瘤病例,该患者自10个月前开始出现左踝关节周围疼痛和肿胀病史。踝关节X线片显示溶骨性膨胀性病变累及整个距骨。由于该患者无法进行病灶内刮除术,故行距骨切除术并随后进行跟骨-胫骨融合术。组织病理学确诊为骨巨细胞瘤。即使在9年的随访中也没有复发迹象,患者能够在没有太多不适的情况下进行日常活动。
骨巨细胞瘤最常见于膝关节或桡骨远端周围。足部骨骼尤其是距骨受累极为罕见。在疾病早期,可采用扩大病灶内刮除术并植骨;在疾病晚期,可选择距骨切除术并进行胫跟融合术作为治疗方案。