Yadav Sandeep Kumar, Choudhary Aakash Kumar, Kantiwal Prabodh, Karmakar Shilpi, Elhence Poonam, Elhence Abhay
Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Marudhar Industrial Area, 2nd phase, M.I.A. 1st phase, Basni, Jodhpur, Rajasthan 342005, India.
Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Marudhar Industrial Area, 2nd phase, M.I.A. 1st phase, Basni, Jodhpur, Rajasthan 342005, India.
Int J Surg Case Rep. 2025 Feb;127:110842. doi: 10.1016/j.ijscr.2025.110842. Epub 2025 Jan 3.
Benign cartilage tumours with malignant transformation are reported very few. Aiming to report a secondary chondrosarcoma in proximal tibia after chondromyxoid fibroma: a rare entity with limited experience of management.
we present a challenging case of secondary chondrosarcoma of proximal tibia in surgically managed chondromyxoid fibroma. Presented to us with recurrent swelling and pain in proximal leg. The diagnosis was confirmed on biopsy and high-grade chondrosarcoma was found. Multidisciplinary approach was taken and treated with neoadjuvant chemotherapy and surgical excision was done with biological reconstruction with fibular strut and iliac crest grafting and soft tissue coverage with medial gastrocnemius muscle flap. The patient achieved good functional outcome with no recurrence at 2-year follow-up.
Benign cartilage tumours mistreated might result in recurrence or malignant transformation. Treatment strategies vary with grade of malignant cartilaginous tumours with low grade chondrosarcoma treated with extensive intralesional curettage followed by local adjuvant treatment and high grade managed with wide excision or amputation.
Even though chondromyxoid fibroma is uncommon and benign, it has a high chance of recurrence and perhaps developing into chondrosarcoma. For better results and to stop progression, appropriate surgical intervention are essential.
关于良性软骨肿瘤发生恶变的报道非常少见。旨在报告一例发生于近端胫骨的软骨黏液样纤维瘤继发软骨肉瘤的病例:这是一种罕见的疾病,治疗经验有限。
我们展示了一例具有挑战性的近端胫骨继发软骨肉瘤病例,该病例最初接受了软骨黏液样纤维瘤的手术治疗。患者因近端腿部反复肿胀和疼痛前来就诊。活检确诊为高级别软骨肉瘤。我们采取了多学科方法,先进行新辅助化疗,然后通过腓骨支撑和髂嵴植骨进行生物重建,并使用内侧腓肠肌肌瓣进行软组织覆盖,实施手术切除。患者在2年随访中功能恢复良好,无复发。
良性软骨肿瘤治疗不当可能导致复发或恶变。治疗策略因恶性软骨肿瘤的分级而异,低级别软骨肉瘤采用广泛的病灶内刮除术,随后进行局部辅助治疗,高级别则采用广泛切除或截肢。
尽管软骨黏液样纤维瘤不常见且为良性,但它有很高的复发几率,甚至可能发展为软骨肉瘤。为了获得更好的治疗效果并阻止病情进展,适当的手术干预至关重要。