Chan K W, Khoo U S, Ho C M
Department of Pathology, University of Hong Kong.
Pathology. 1993 Apr;25(2):193-6. doi: 10.3109/00313029309084799.
A polypoid fibro-osseous nodule arising from the soft tissues of a toe of a 17 yr old man is described. Initial partial excision of the nodule led to a wrong diagnosis of pyogenic granuloma. The mistaken diagnosis was based on finding an extensively ulcerated polypoid nodule with a core of fibrovascular tissue which resembled granulation tissue. The fast growing lesion recurred twice within 4 mths following incomplete excisions. Bony destruction of the distal phalanx was noted radiologically at the second recurrence. The rare lesion is an example of fibro-osseous pseudotumor of the digits, sometimes described as pseudomalignant osseous tumor of the soft tissues. It is curable by complete local resection. The importance of recognizing this lesion lies in its potential to be confused with parosteal or extraskeletal osteosarcoma. The fast growth rate of present case led to a strong clinical suspicion of malignancy. Incomplete excisions resulted in local recurrences rendering more extensive surgery necessary. There was no further recurrence 12 mths after the last excision.
本文描述了一名17岁男性脚趾软组织出现的息肉样纤维骨性结节。结节最初的部分切除导致了脓性肉芽肿的误诊。错误诊断的依据是发现一个广泛溃疡的息肉样结节，其核心为类似肉芽组织的纤维血管组织。在不完全切除后的4个月内，这个快速生长的病变复发了两次。在第二次复发时，影像学检查发现远端指骨有骨质破坏。这种罕见病变是指骨纤维骨性假瘤的一个例子，有时被描述为软组织假恶性骨肿瘤。通过完整的局部切除可治愈。认识到这种病变的重要性在于它有可能与骨旁或骨外骨肉瘤相混淆。本病例的快速生长速度导致临床上强烈怀疑为恶性肿瘤。不完全切除导致局部复发，使得更广泛的手术成为必要。最后一次切除12个月后未再复发。
