Furuta T, Sakuda T, Yoshioka K, Arihiro K, Adachi N
Department of Orthopaedic Surgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Department of Pathology, Hiroshima University Hospital, Hiroshima, Japan.
Int J Surg Case Rep. 2023 Jul;108:108379. doi: 10.1016/j.ijscr.2023.108379. Epub 2023 Jun 2.
Patellar bone tumors are very rare, and most are benign or of intermediate type. In this report, we describe our experience of a metastatic patellar bone tumor caused by gastric cancer, which resembled a very rare primary or secondary aneurysmal bone cyst and review the literature.
A 65-year-old man presented with severe pain in the patellar region and marked limitation of the knee joint range of motion. He had a history of gastric cancer; however, epidemiological, clinical, and imaging findings led us to strongly suspect an aneurysm-like bone cyst. Thus, we performed bone tumor curettage and autologous artificial bone grafting without biopsy because of the severe pain. Pathology results showed gastric cancer metastasis; hence, patellectomy and patellar tendon augmentation with femoral fascia were performed. The Musculoskeletal Tumor Society (MSTS) score was taken postoperatively to assess pain and function.
We experienced a very rare gastric cancer-related metastatic patellar bone tumor, which resembled a primary or secondary aneurysmal bone cyst in frequency and imaging findings. Patellectomy was ultimately performed, and the patient's MSTS score improved markedly.
Despite its very low frequency, patellar metastatic bone tumors must be taken into account without being misled by the frequency or imaging findings and a biopsy should necessarily be performed.
髌骨骨肿瘤非常罕见,且大多数为良性或中间型。在本报告中,我们描述了一例由胃癌引起的转移性髌骨骨肿瘤的病例,该肿瘤类似于一种非常罕见的原发性或继发性动脉瘤样骨囊肿,并对相关文献进行了综述。
一名65岁男性因髌骨区域剧痛及膝关节活动范围明显受限前来就诊。他有胃癌病史;然而,流行病学、临床及影像学检查结果使我们强烈怀疑为动脉瘤样骨囊肿。因此,由于疼痛剧烈,我们在未进行活检的情况下实施了骨肿瘤刮除术及自体人工骨移植。病理结果显示为胃癌转移;因此,我们进行了髌骨切除术及用股筋膜加强髌腱。术后采用肌肉骨骼肿瘤学会(MSTS)评分来评估疼痛及功能。
我们遇到了一例非常罕见的与胃癌相关的转移性髌骨骨肿瘤,其在发病率及影像学表现上类似于原发性或继发性动脉瘤样骨囊肿。最终实施了髌骨切除术,患者的MSTS评分显著改善。
尽管髌骨转移性骨肿瘤的发病率极低,但在诊断时不能受发病率或影像学表现的误导而忽视它,必须进行活检。