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肘关节内骨软骨瘤:1 例 8 岁男孩的诊断与手术治疗

Intra-Articular Osteochondroma in the Elbow: Diagnosis and Surgical Treatment in an 8-Year-Old Boy.

机构信息

Department of Orthopaedics, Aseer Central Hospital Abha, and King Khalid University, Abha, Saudi Arabia.

Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.

出版信息

Am J Case Rep. 2024 Oct 27;25:e943927. doi: 10.12659/AJCR.943927.

DOI:10.12659/AJCR.943927
PMID:39462146
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11526171/
Abstract

BACKGROUND Osteochondroma is the most common bone tumor and is a surface bone lesion that includes cortical and medullary bone with a hyaline cartilage cap. Benign osteochondroma is a common tumor in children that may be asymptomatic but can cause pain and limit joint movement when arising in a joint. This report describes the presentation, diagnosis, and management of an intra-articular osteochondroma of the right elbow joint in an 8-year-old boy. CASE REPORT An 8-year-old boy experienced persistent right elbow pain and limited motion, which were unresponsive to conservative measures. Examination revealed a firm swelling in the right cubital fossa. Radiographic and advanced imaging confirmed an osteochondroma originating from the capitellum and trochlea. Surgical exploration via a lateral approach and capsulotomy excised a lobulated intra-articular mass (5×2×1.5 cm). Histopathology showed a hyaline cartilage cap with typical chondrocytes and endochondral ossification, and normal fatty marrow and hematopoietic elements in the stroma. The procedure restored normal elbow function. This case is the first documented instance of an elbow joint intra-articular osteochondroma. CONCLUSIONS This report has highlighted the importance of surgical removal and histopathology in the diagnosis of this common bone lesion to exclude the differential diagnoses of intra-articular masses that include a foreign body, enchondroma, chondroblastoma, periosteal chondroma, chondromyxoid fibroma, or malignant chondrosarcoma.

摘要

背景

骨软骨瘤是最常见的骨肿瘤,是一种包括皮质骨和髓质骨的表面骨病变,伴有透明软骨帽。良性骨软骨瘤是儿童的常见肿瘤,可能无症状,但在关节内生长时会引起疼痛和限制关节运动。本报告描述了一名 8 岁男孩右肘关节内骨软骨瘤的表现、诊断和治疗。

病例报告

一名 8 岁男孩出现持续性右肘部疼痛和运动受限,保守治疗无效。检查发现右肘窝有一坚实肿块。影像学和高级影像学检查证实起源于肱骨小头和滑车的骨软骨瘤。通过外侧入路进行手术探查和囊切开术切除了一个分叶状关节内肿块(5×2×1.5 cm)。组织病理学显示透明软骨帽,有典型的软骨细胞和成软骨内骨化,基质中有正常的脂肪骨髓和造血成分。该手术恢复了正常的肘部功能。这是首例记录在案的肘关节内骨软骨瘤。

结论

本报告强调了手术切除和组织病理学在诊断这种常见骨病变中的重要性,以排除关节内肿块的鉴别诊断,包括异物、内生软骨瘤、软骨母细胞瘤、骨膜软骨瘤、软骨粘液纤维瘤或恶性软骨肉瘤。

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本文引用的文献

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Conservative and Surgical Treatment of Osteochondromas in Children, Particularly with or without Surgical Lengthening of the Ulna.儿童骨软骨瘤的保守治疗与手术治疗,尤其是伴有或不伴有尺骨手术延长的情况。
J Clin Med. 2023 Jun 26;12(13):4273. doi: 10.3390/jcm12134273.
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Chondrosarcoma: A Clinical Review.软骨肉瘤:临床综述
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Benign Bone Tumors: An Overview of What We Know Today.良性骨肿瘤:我们现今所知的概述
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Enchondroma in the Diaphysis of Tibia - A Case Report and Review of its Characteristics and Differentials in the Diaphysis.胫骨骨干内生软骨瘤——病例报告及其在骨干中的特征与鉴别诊断综述
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Understanding the Action of RARγ Agonists on Human Osteochondroma Explants.了解 RARγ 激动剂对人软骨瘤外植体的作用。
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Periosteal chondroma of the femur: A case report and review of the literature.股骨骨膜软骨瘤:一例报告并文献复习
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