■骨软骨瘤是最常见的骨良性肿瘤,可以是无柄的或有蒂的。虽然骨软骨瘤通常见于长骨,它们很少在手或脚的小骨头中看到。寻常疣,也被称为普通疣,是医生最常见的皮肤疾病之一,必须在临床或组织学上与其他过度角化疾病区分开来,包括骨骼疾病,如骨肿瘤,可以对皮肤施加压力,并导致骨痂形成,可以模仿疣或造成皮肤畸形。在评估患者的皮肤状况时,应考虑高度怀疑潜在的骨量或肿瘤。特别是手或脚,无法通过治疗改善。
■该病例报告介绍了一名20岁的男性,其左第四指骨远端有蒂骨软骨瘤,角化过度的皮肤覆盖脚趾末端的肿块。最初由家庭医生和足病医生治疗寻常疣超过5年,当治疗足病医生遇到骨骼和推荐的X光片时,他采用液氮冷冻疗法和手术切除肿块的两种治疗方法。几天后,家人被告知患者患有骨肿瘤后,要求对我们的实践进行随访。患者要求手术切除继发于疼痛的骨软骨瘤,其活动和作为飞行员的职业困难。
所有医生都必须注意出现皮肤变化的患者的潜在骨肿瘤或肿块,尤其是脚或手。在评估和治疗患有皮肤病变的患者时,知道潜在的骨肿瘤可以表现为寻常疣,可以防止诊断延迟或不必要的治疗。幸运的是,我们的病例是良性骨软骨瘤;恶性肿瘤延迟诊断可能导致肢体或生命丧失.
UNASSIGNED: Osteochondromas are the most common benign tumors of the bone and can be sessile or pedunculated. Although osteochondromas are typically seen in the long bones, they are rarely seen in the small bones of the hand or foot. Verruca vulgaris, also known as the common wart, is one of the most common skin conditions presenting to physicians and must be distinguished either clinically or histologically from other hyperkeratotic conditions, including bone conditions such as bone tumors that can place pressure on the skin and cause callus formation that can mimic a wart or create skin deformity. A high index of suspicion for underlying bone mass or tumor should be entertained when evaluating patients for skin conditions, particularly of the hand or foot, with failure to improve with treatment.
UNASSIGNED: This
case report presents a 20-year-old male with a pedunculated osteochondroma of the left fourth distal phalanx with hyperkeratotic skin overlying the mass at the end of the toe. He was initially treated by a family doctor and podiatrist for verruca vulgaris for over 5 years with two treatments of liquid nitrogen cryotherapy and surgical excision of the mass when the treating podiatrist encountered bone and recommended radiographs. The family requested follow-up with our practice several days later after they were told the patient had a bone tumor. The patient requested surgical excision of the osteochondroma secondary to pain with activities and difficulties with his vocation as a pilot.
UNASSIGNED: All physicians must be mindful of an underlying bone tumor or mass in patients presenting with skin changes, particularly about the foot or hand. Knowledge that an underlying bone tumor can present as a verruca vulgaris may prevent a delay in diagnosis or unnecessary treatment when evaluating and treating a patient with a skin lesion. Fortunately, our
case was a benign osteochondroma; a malignant tumor with a delay in diagnosis could lead to loss of limb or life.