Safiullah Mohamed, Reddy Vijay Narasimman, Reddy Rajlaxmi, Reddy Ramchandra
Department of Orthopaedics, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
J Orthop Case Rep. 2025 Jun;15(6):44-47. doi: 10.13107/jocr.2025.v15.i06.5658.
Fibrous dysplasia is a rare, benign bone disorder characterized by fibro-osseous replacement of normal bone.
We report the case of a 22-year-old female who presented with chronic left arm pain and a history of pathological fracture of the left humerus. Radiological imaging revealed an ill-defined intramedullary mixed sclerotic and lytic lesion suggestive of fibrous dysplasia. The patient underwent bone curettage and grafting, and the sample was sent for histopathological examination. Surprisingly, the histology showed fungal spores, with no evidence of neoplasia. The patient had no known immunocompromised state or predisposing factors.
This case emphasizes the importance of considering rare infectious causes such as fungal osteomyelitis in the differential diagnosis of tumor-like bone lesions, even in immunocompetent individuals. Early tissue diagnosis is critical to avoid mismanagement and to initiate appropriate antifungal treatment.
骨纤维异常增殖症是一种罕见的良性骨疾病,其特征是正常骨被纤维-骨组织替代。
我们报告一例22岁女性病例,该患者出现慢性左臂疼痛且有左肱骨病理性骨折病史。放射影像学检查显示髓腔内有边界不清的混合性硬化及溶骨性病变,提示骨纤维异常增殖症。患者接受了骨刮除术及植骨术,并将样本送去做组织病理学检查。令人惊讶的是,组织学检查显示有真菌孢子,无肿瘤形成证据。该患者无已知的免疫功能低下状态或诱发因素。
该病例强调了在肿瘤样骨病变的鉴别诊断中考虑罕见感染原因(如真菌性骨髓炎)的重要性,即使在免疫功能正常的个体中也是如此。早期组织诊断对于避免治疗不当及启动适当的抗真菌治疗至关重要。