PDF(Pubmed)
Abstract：
A giant cell tumor is a common, benign but locally aggressive bone tumor faced by orthopedic surgeons. The proximal humerus is a rare site of occurrence for this tumor, and the challenges posed while approaching such a case are discussed in this report of a 29-year-old male who presented with pain, swelling, and restricted motion at the left shoulder. Plain radiographs and MRI were suggestive of an aggressive giant cell tumor of the proximal humerus, which was confirmed on histopathological examination. Due to the lesion\'s extensive soft-tissue involvement, en-bloc resection with reconstruction was planned, but due to the COVID-19 pandemic, surgery was delayed. During the same period, the patient had trivial trauma to the same shoulder, following which the size of the lesion began increasing. The patient was operated on with en-bloc resection and reconstruction with a custom megaprosthesis; following the surgery, there was a complete resolution of pain and improvement in the range of motion. En bloc resection and replacement with a customized megaprosthesis, though technically demanding, offer a safe and cost-effective modality for limb salvage surgery for large giant cell tumors, with good functional outcomes and decreased chances of recurrence.
摘要：
巨细胞瘤是一种常见的肿瘤,骨科医生面临的良性但局部侵袭性骨肿瘤。肱骨近端是这种肿瘤的罕见发生部位，在处理这种情况时所面临的挑战在这份报告中讨论了一名29岁的男性，他表现出疼痛，肿胀,左肩活动受限.平片和MRI提示肱骨近端侵袭性巨细胞瘤，这在组织病理学检查中得到证实。由于病变广泛的软组织受累，计划进行整块切除和重建，但是由于COVID-19大流行，手术推迟了。在同一时期,病人的同肩有轻微的外伤,随后，病变的大小开始增加。患者采用定制的巨型假体进行整块切除和重建手术；手术后，疼痛完全缓解，运动范围改善。用定制的巨型假体进行整体切除和置换，尽管技术要求很高，为大型巨细胞瘤的保肢手术提供一种安全且具有成本效益的方式，具有良好的功能结局和减少的复发机会。
