■骨是肺癌常见的转移部位之一。股骨病理性骨折显著降低患者的生活质量并增加死亡风险。然而,对于病理性股骨骨折的最佳治疗仍未达成共识。作者报告为肺癌病理性骨折患者提供了一种术前HIFU病灶消融后联合髓内钉固定的治疗方法。
一名61岁的中国妇女因右侧大腿剧烈疼痛住院。入院时X线和CT检查考虑右侧股骨病理性骨折。MRI显示右股骨中下部粉碎性骨折,周围软组织肿胀,和积液。WBS显示右侧股骨骨折端显像剂浓度异常,骨代谢异常。肺活检后,诊断为肺癌伴股骨转移及病理性骨折。
■患者在手术前接受了HIFU消融以减少病变,重新检查MRI显示病变处的信号明显减弱,病变体积明显缩小。手术采用切开复位髓内钉固定,病灶切除,和骨水泥填充。经过6个月的随访,患者骨转移未加重,右股髓内钉无松动或骨折。
■这是一例由肺癌骨转移引起的股骨病理性骨折。患者术前采用HIFU缩小病灶,结合髓内钉内固定治疗病理性骨折。取得了满意的治疗效果。作者认为这是一种安全有效的治疗方法。此病例可能有益于肺癌骨转移病理性骨折的治疗。
UNASSIGNED: Bone is one of the common sites of metastasis in lung cancer. Pathological fractures of the femur significantly reduce patients\' quality of life and increase the risk of death. However, there is still no consensus on the optimal treatment of pathological
femoral fractures. The authors\' report provides a treatment method for a patient with pathological fracture of lung cancer with preoperative HIFU lesion ablation followed by combined intramedullary nail fixation.
UNASSIGNED: A 61-year-old Chinese woman was hospitalized with severe pain in her right thigh. X-ray and CT examination at admission considered pathological fracture of the right femur. MRI showed a comminuted fracture of the middle and lower part of the right femur, swelling of the surrounding soft tissue, and effusion. WBS showed an abnormal concentration of imaging agent at the right
femoral fracture end and abnormal bone metabolism. After a lung biopsy, it was diagnosed as lung cancer with
femoral metastasis and pathological fracture.
UNASSIGNED: The patient underwent HIFU ablation before surgery to reduce the lesion, and a re-examination MRI showed that the signal at the lesion was significantly reduced, and the lesion volume was significantly reduced. The operation was performed by open reduction and intramedullary nail fixation, focal excision, and bone cement filling. After 6 months of follow-up, the patient\'s bone metastasis was not aggravated, and there was no loosening or fracture of the right femoral intramedullary nail.
UNASSIGNED: This is a
case of pathological fracture of the femur caused by bone metastases from pulmonary cancer. The patient used HIFU to reduce the lesion before the operation and combined it with intramedullary nail internal fixation to treat the pathological fracture. A satisfactory therapeutic effect was obtained. The authors believe that this is a safe and effective treatment. This
case may be beneficial to the treatment of pathological fracture of bone metastasis of lung cancer.