背景:骨样骨瘤是一种相对常见的良性骨形成性病变,通常发生在患有下肢和脊柱的年轻人中。它的特点是类骨组织的形成,骨头的前兆,并可在受影响地区引起疼痛和活动受限。手部和手指的骨样骨瘤很少见,因此代表了诊断挑战。患者的父亲提供了一份书面知情同意书,以发表并分享有关患者的所有图像和临床数据。
方法:我们报告一例11岁女孩,她的左手食指持续疼痛和肿胀,以及有限的机动性,在1年的过程中。非甾体抗炎药缓解了疼痛,但一旦停药,它就会重新出现。
方法:一系列调查,显示第二近端指骨颈部有溶解性病变,具有骨样骨瘤的特征。
方法:切除植骨作为确定性治疗,病理证实骨样骨瘤诊断。然而,该患者在2年后因以前的症状复发而返回,进一步的测试表明骨样骨瘤复发。为了解决复发,使用了改良的开放式热消融技术.热消融是一种微创手术,利用热量破坏肿瘤细胞,它已被证明对治疗骨样骨瘤有效。改良的开放方法包括制作一个小切口以进入肿瘤,并通过先前CT引导的插入的克氏针直接将热量传递到受影响的区域。
结果:患者报告术后1个月和1年无疼痛,没有复发的放射学迹象,表明病变完全切除。
结论:总体而言,这个案例突出了诊断和治疗手和手指骨样骨瘤的挑战。需要进一步的研究来更好地了解根本原因,潜在风险因素,骨样骨瘤复发的最佳治疗方法。
BACKGROUND: Osteoid osteoma is a relatively common benign bone-forming lesion that often occurs in young adults with a predilection for the lower limbs and spine. It is characterized by the formation of osteoid tissue, a precursor to bone, and can cause pain and restricted mobility in affected areas. Osteoid osteoma of the hand and fingers is rare, thus representing a diagnostic challenge. A written informed consent was provided from the patient\'s father for the publication and sharing all images and clinical data concerning the patient.
METHODS: We are reporting a
case of an 11-year-old girl who presented with persistent pain and swelling in her left index finger, as well as limited mobility, over the course of 1 year. Nonsteroidal anti-inflammatory drugs eased the pain, but it resurfaced once the medication was discontinued.
METHODS: A series of investigations, showed a lytic lesion at the second proximal phalangeal neck, with features indicative of osteoid osteoma.
METHODS: Excision with bone grafting was performed as definitive therapy with pathological confirmation of the osteoid osteoma diagnosis. Nevertheless, the patient returned 2 years later with a recurrence of her previous symptoms, and further tests suggested a recurrence of osteoid osteoma. To address the recurrence, a modified open thermoablation technique was used. Thermoablation is a minimally invasive procedure that uses heat to destroy the tumor cells, and it has been shown to be effective in treating osteoid osteoma. The modified open approach involves making a small incision to access the tumor and delivering heat directly through a previously CT-guided inserted Kirschner wire to the affected area.
RESULTS: The patient reported no pain at 1 month and 1 year after the surgery, with no radiological signs of recurrence, indicating complete excision of the lesion.
CONCLUSIONS: Overall, this
case highlights the challenges of diagnosing and treating osteoid osteoma in the hands and fingers. Further research is needed to better understand the underlying causes, potential risk factors, and optimal treatment for osteoid osteoma recurrence.