Cha Myung-Jin, Kubsad Sanjay, Haft Mark, Levin Adam S, Nikkel Lucas E
Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, USA.
Department of Orthopedic Oncology, Johns Hopkins University, Baltimore, USA.
Cureus. 2024 Aug 27;16(8):e67943. doi: 10.7759/cureus.67943. eCollection 2024 Aug.
A 67-year-old male with a past medical history of coronary artery disease, hypertension, and obesity presented with severe left knee pain and severe tricompartmental osteoarthritis. After failing conservative treatments and completing a preoperative medical workup, the patient was scheduled for total knee arthroplasty. Intraoperatively, a pathologic fracture of the distal femur was discovered, and the procedure was aborted. Histopathologic evaluation of the femur fracture revealed diffuse large B-cell lymphoma. Intraoperative discovery of a pathologic fracture should be treated as an underlying malignancy until proven otherwise. In these cases, surgery should be aborted until definitive diagnosis and management can be planned.
一名67岁男性,有冠状动脉疾病、高血压和肥胖病史,因左膝严重疼痛和严重的三关节腔骨关节炎就诊。在保守治疗失败并完成术前医学检查后,该患者被安排进行全膝关节置换术。术中发现股骨远端病理性骨折,手术中止。股骨骨折的组织病理学评估显示为弥漫性大B细胞淋巴瘤。术中发现病理性骨折在未得到其他证实之前应被视为潜在的恶性肿瘤。在这些情况下,应中止手术,直到能够制定明确的诊断和治疗方案。