Abstract：
BACKGROUND: Low-grade myofibroblastic sarcoma (LGMS) is an atypical type of tumor composed of myofibroblasts. LGMS in the femoral head neck junction is extremely rare and no case treated by hip arthroscopy was reported.
METHODS: We reported a case of LGMS in the femoral head neck junction treated by hip arthroscopy. A 30-year-old female was admitted to our hospital with discomfort and pain after left hip sprained one year prior. Physical examination revealed swelling of the left hip and magnetic resonance images showed a soft tissue mass in the femoral head neck junction.
METHODS: Via microscopy of pathological specimens, spindle cell proliferative lesions, atypia of some cells, and mitotic figures/pathological mitotic figures of some cells were observed. Immunohistochemistry revealed positive for smooth muscle actin, focally positive for CD34 and CD68, while negative for S-100, desmin, and anaplastic lymphoma kinase. The imaging, histomorphological and immunohistochemical features suggested a final diagnosis of LGMS of the proximal femur.
METHODS: This patient underwent hip arthroscopy for excision of the soft tissue mass.
RESULTS: The clinical and imaging follow-up at 6 months postoperatively showed that surgery had achieved good clinical outcomes.
CONCLUSIONS: To the best of our knowledge, this is the first case report of LGMS in the femoral head neck junction treated by hip arthroscopy. Beyond the present case, other 120 cases from 58 literatures (1998-2022) are reviewed and discussed. The age of LGMS patients ranged from 11 months to 77 years and the male-to-female ratio was approximately 1.28:1. The location distribution of previously reported LGMS cases and the present case was as follows: Head&neck (45.90%), trunk (30.33%), and extremity (23.77%). Hip arthroscopic excision of LGMS may achieve relatively good clinical outcomes.
METHODS: We reported a case of LGMS in the femoral head neck junction treated by hip arthroscopy. A 30-year-old female was admitted to our hospital with discomfort and pain after left hip sprained one year prior. Physical examination revealed swelling of the left hip and magnetic resonance images showed a soft tissue mass in the femoral head neck junction.
METHODS: Via microscopy of pathological specimens, spindle cell proliferative lesions, atypia of some cells, and mitotic figures/pathological mitotic figures of some cells were observed. Immunohistochemistry revealed positive for smooth muscle actin, focally positive for CD34 and CD68, while negative for S-100, desmin, and anaplastic lymphoma kinase. The imaging, histomorphological and immunohistochemical features suggested a final diagnosis of LGMS of the proximal femur.
METHODS: This patient underwent hip arthroscopy for excision of the soft tissue mass.
RESULTS: The clinical and imaging follow-up at 6 months postoperatively showed that surgery had achieved good clinical outcomes.
CONCLUSIONS: To the best of our knowledge, this is the first case report of LGMS in the femoral head neck junction treated by hip arthroscopy. Beyond the present case, other 120 cases from 58 literatures (1998-2022) are reviewed and discussed. The age of LGMS patients ranged from 11 months to 77 years and the male-to-female ratio was approximately 1.28:1. The location distribution of previously reported LGMS cases and the present case was as follows: Head&neck (45.90%), trunk (30.33%), and extremity (23.77%). Hip arthroscopic excision of LGMS may achieve relatively good clinical outcomes.
摘要：
背景：低度肌纤维母细胞肉瘤（LGMS）是一种由肌纤维母细胞组成的非典型肿瘤。股骨头颈交界处的LGMS极为罕见，没有报告通过髋关节镜检查治疗的病例。
方法：我们报告了1例股骨颈交界处LGMS患者的髋关节镜治疗。一名30岁女性在一年前左髋关节扭伤后因不适和疼痛入院。体格检查显示左髋关节肿胀，磁共振图像显示股骨头颈交界处有软组织肿块。
方法：通过病理标本的显微镜，梭形细胞增生性病变，一些细胞的异型性，并观察到一些细胞的有丝分裂图/病理有丝分裂图。免疫组织化学显示平滑肌肌动蛋白阳性，CD34和CD68呈局灶性阳性，而S-100呈阴性，结蛋白，和间变性淋巴瘤激酶。成像，组织形态学和免疫组织化学特征提示股骨近端LGMS的最终诊断。
方法：该患者接受髋关节镜检查切除软组织肿块。
结果：术后6个月的临床和影像学随访显示，手术取得了良好的临床效果。
结论：据我们所知，这是第一例通过髋关节镜治疗的股骨头颈交界处LGMS。除了目前的情况，回顾并讨论了58篇文献（1998-2022）中的其他120例。LGMS患者的年龄范围为11个月至77岁，男女比例约为1.28：1。先前报告的LGMS病例和当前病例的位置分布如下：头颈部（45.90％），树干(30.33%)，和四肢（23.77%）。关节镜下LGMS切除术可能取得相对较好的临床疗效。
方法：我们报告了1例股骨颈交界处LGMS患者的髋关节镜治疗。一名30岁女性在一年前左髋关节扭伤后因不适和疼痛入院。体格检查显示左髋关节肿胀，磁共振图像显示股骨头颈交界处有软组织肿块。
方法：通过病理标本的显微镜，梭形细胞增生性病变，一些细胞的异型性，并观察到一些细胞的有丝分裂图/病理有丝分裂图。免疫组织化学显示平滑肌肌动蛋白阳性，CD34和CD68呈局灶性阳性，而S-100呈阴性，结蛋白，和间变性淋巴瘤激酶。成像，组织形态学和免疫组织化学特征提示股骨近端LGMS的最终诊断。
方法：该患者接受髋关节镜检查切除软组织肿块。
结果：术后6个月的临床和影像学随访显示，手术取得了良好的临床效果。
结论：据我们所知，这是第一例通过髋关节镜治疗的股骨头颈交界处LGMS。除了目前的情况，回顾并讨论了58篇文献（1998-2022）中的其他120例。LGMS患者的年龄范围为11个月至77岁，男女比例约为1.28：1。先前报告的LGMS病例和当前病例的位置分布如下：头颈部（45.90％），树干(30.33%)，和四肢（23.77%）。关节镜下LGMS切除术可能取得相对较好的临床疗效。
