osteochondroma

骨软骨瘤
  • 文章类型: Case Reports
    背景:第一肋骨肿瘤极为罕见。其压迫神经血管容易导致严重的并发症,如胸廓出口综合征,所以早期手术切除至关重要。然而,没有标准化的手术方法。
    方法:一名先前健康的18岁中国男性接受了胸部计算机断层扫描(CT)扫描,该扫描偶然发现了右侧第一肋骨上的钙化块,与磁共振成像(MRI)结合时,最有可能是骨软骨瘤。通过在前胸部采用倒L形切口和胸骨的纵向分裂,我们在切除和胸部重建方面取得了出色的效果。
    结论:我们的实践为第一肋骨肿瘤的外科治疗提供了很好的参考。
    BACKGROUND: First rib tumors are extremely rare. Its compression of neurovascularity can easily lead to severe complications such as thoracic outlet syndrome, so early surgical resection is crucial. However, there is no standardized approach to surgery.
    METHODS: A previously healthy 18-year-old Chinese male undergoes a chest computed tomography (CT) scan that incidentally reveals a raised calcified mass on the right first rib, which is most likely an osteochondroma when combined with magnetic resonance imaging (MRI). We achieved excellent results with resection and thoracic reconstruction by adopting an inverse L-shaped incision in the anterior chest and a longitudinal split of the sternum.
    CONCLUSIONS: Our practice provides great reference for the surgical management of first rib tumors.
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  • 文章类型: Journal Article
    奇异的骨旁骨软骨瘤增生(BPOP),也被称为诺拉病变,是一种罕见的,良性肿瘤最常位于手和脚。我们在此介绍第二例BPOP影响脊柱的报道,一个不寻常的位置。手术切除一年后,患者无痛且无复发迹象.我们回顾了101篇文献中的323例BPOP,提供有关BPOP最新知识的首次系统更新。BPOP患者的年龄范围从3个月到87岁,在生命的第二个和第三个十年达到顶峰。双手是BPOP最常见的位置(58.39%),其次是脚(20.81%)。影像学特征在BPOP的诊断中起关键作用,但组织病理学诊断仍是金标准.BPOP的鉴别诊断应基于流行病学和临床特征以及临床检查结果。手术切除是BPOP最广泛使用的治疗方法。复发是常见的(37.44%),可以通过再次切除治疗。本文可加深对BPOP的认识,为临床上BPOP的诊断和治疗提供帮助。
    Bizarre parosteal osteochondromatous proliferation (BPOP), also termed Nora lesion, is a rare, benign tumor most often located in the hands and feet. We herein present the second reported case of BPOP affecting the spine, an uncommon location. One year after surgical excision, the patient was pain-free and showed no evidence of recurrence. We reviewed a total of 323 cases of BPOP among 101 articles, providing the first systematic update on the latest knowledge of BPOP. The age of patients with BPOP ranges from 3 months to 87 years, peaking in the second and third decades of life. The hands are the most common location of BPOP (58.39%), followed by the feet (20.81%). Imaging features play a key role in the diagnosis of BPOP, but histopathologic diagnosis remains the gold standard. Differential diagnosis of BPOP should be based on the epidemiologic and clinical features as well as clinical examination findings. Surgical resection is the most extensively used treatment for BPOP. Recurrence is common (37.44%) and can be treated with re-excision. This article can deepen our understanding of BPOP and will be helpful for the diagnosis and treatment of BPOP in clinical practice.
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  • 文章类型: Case Reports
    多发性遗传性骨外生症是一种罕见的常染色体显性遗传性骨疾病,在西方人群中以1:50,000至1:100,000的发病率主要影响男性。病因归因于EXT基因群的突变,特别是导致骨软骨瘤形成的EXT1和EXT2。诊断通常在儿童时期建立。然而,血管并发症极为罕见,但可能致命。因此,及时诊断和治疗对此类患者至关重要。
    方法:我们介绍了一例37岁的中东男性,患有多发性遗传性骨外生症,在入院前经历了突然发作的左下肢疼痛持续一个月。它与同侧下肢的寒冷和感觉异常有关。术前放射学检查发现了多发性遗传性外结瘤后的pop假性动脉瘤。
    通过开放手术,血管灌注成功恢复,随后通过大隐静脉移植进行上至膝下动脉吻合。此外,骨软骨瘤被完全切除以限制另一次血管损伤的复发。以下组织病理学分析证实了MHE结果的骨软骨瘤的诊断。
    结论:多发性遗传性外结瘤是导致假性动脉瘤的罕见病例。这一事件强调需要进一步的文件来帮助建立及时的诊断和进行适当的干预。在多学科方法中考虑这种病理学可确保适当的治疗。经过全面的文献综述,我们的案例是我国出版文献中第一个强调其价值和稀有性的案例。
    UNASSIGNED: Multiple Hereditary Exostoses is a rare autosomal dominant bone disorder that predominantly affects males at an incidence of (1:50,000 to 1:100,000) in Western populations. The etiology is owed to mutations in the EXT gene group, specifically EXT1 and EXT2 which cause the formation of Osteochondromas. Diagnosis is typically established in childhood. Nevertheless, vascular complications are extremely rare while being potentially fatal. Therefore, timely diagnosis and treatment are vital for such patients.
    METHODS: We present the case of a 37-year-old Middle Eastern male with Multiple Hereditary Exostoses who experienced sudden-onset left lower limb pain persisting for a month prior to admission. It was associated with coldness and paresthesia of the ipsilateral lower limb. The presurgical radiological workup uncovered a popliteal pseudoaneurysm subsequent to Multiple Hereditary Exostoses.
    UNASSIGNED: Through open surgery, the vascular perfusion was successfully restored, and a subsequent supra- to infra-geniculate popliteal artery anastomosis via saphenous vein grafting was done. Furthermore, the Osteochondroma was utterly resected to limit recurrence of another vascular injury. The following histopathological analysis confirmed the diagnosis of an Osteochondroma as a result of MHE.
    CONCLUSIONS: Multiple Hereditary Exostoses is a rare occurrence leading to pseudoaneurysms. This event underscores the need for further documentation to aid in establishing a prompt diagnosis and carrying out suitable interventions. Considering this pathology in a multidisciplinary approach ensures proper treatment. Following a comprehensive literature review, our case stands as the first case in the published literature from our country which emphasizes its value and rarity.
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  • 文章类型: Review
    背景:骨软骨瘤,被归类为脂肪瘤的一种新的良性亚型,以软骨样和骨分化为特征,是以前文献中很少报道的罕见病变。据报道,颌面部区域是最常见的定位,在下肢很少发生。本文代表了足部骨软骨脂肪瘤的首例文献报道。
    方法:一名51岁男性患者主诉右脚足底疼痛,伴随着第一和第二meta骨之间肿胀的观察。他对疼痛和肿胀的抱怨始于10年和4年前,分别。自从他们发病以来,这两种症状都有进展。成像揭示了一个大肿块,表现出纤维组织和骨骼结构的非均匀成分。建议通过全切除进行手术干预。
    结论:骨性脂肪瘤是一种良性病变,可影响足部,由于疼痛和肿胀导致足部功能下降。手术切除是该病变的推荐方法,通过组织病理学检查提供症状缓解和诊断确认。
    BACKGROUND: Osteochondromas, classified as a new benign subtype of lipomas and characterised by chondroid and osseous differentiation, are rare lesions that have been infrequently reported in previous literature. The maxillofacial region was reported as the most frequent localization, with infrequent occurrence in the lower limb. This paper represents the first documented case report of osteochondrolipoma in the foot.
    METHODS: A 51-year-old male patient presented with a chief complaint of right foot pain at the plantar aspect, accompanied by the observation of swelling between the first and the second metatarsal shafts. His complaint of pain and swelling started 10 and 4 years prior, respectively. Since their onset, both symptoms have progressed in nature. Imaging revealved a large mass exhibiting a nonhomogenous composition of fibrous tissue and bony structures. Surgical intervention through total excision was indicated.
    CONCLUSIONS: Osteochodrolipoma is a benign lesion that can affect the foot leading to decreased functionality of the foot due to the pain and swelling. Surgical excision is the recommended approach for this lesion, providing both symptomatic relief and confirmation of the diagnosis through histopathological examination.
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  • 文章类型: Case Reports
    颅内骨软骨瘤是罕见的,由于影像学发现与其他病理重叠,提出了诊断挑战。此病例报告强调了在骨附近钙化的肿瘤分化中考虑骨软骨瘤的重要性。
    一名34岁的男性视力下降和头痛,MRI显示鞍上病变。术中,骨性硬肿瘤被部分切除。随后的计算机断层扫描(CT)证实钙化肿块与后斜骨相邻。
    回顾28例,颅底骨软骨瘤很常见,鉴别诊断包括颅咽管瘤和脑膜瘤。手术决策涉及平衡凸性和假性病例的完全切除与由于靠近关键结构而对颅底肿瘤的部分切除。
    颅内骨软骨瘤提出了诊断挑战,尤其是骨头附近。量身定制的手术方法至关重要,对于凸性和假性病例,完全切除可产生良好的结果。密切随访对于监测复发和并发症至关重要。
    UNASSIGNED: Intracranial osteochondroma is rare, presenting diagnostic challenges due to overlapping imaging findings with other pathologies. This case report highlights the significance of considering osteochondroma in calcified tumour differentials near bone.
    UNASSIGNED: A 34-year-old man with vision deterioration and headaches had an MRI revealing a suprasellar lesion. Intraoperatively, a bony hard tumour was partially resected. Subsequent computed tomography (CT) confirmed a calcified mass contiguous with the posterior clinoid.
    UNASSIGNED: Reviewing 28 cases, skull base osteochondromas were common, with differential diagnoses including craniopharyngioma and meningioma. Surgical decision-making involved balancing complete resection for convexity and falx cases versus partial resection for skull base tumours due to proximity to critical structures.
    UNASSIGNED: Intracranial osteochondroma poses diagnostic challenges, especially near bone. Tailored surgical approaches are vital, with complete resection yielding good outcomes for convexity and falx cases. Close follow-up is crucial for monitoring recurrences and complications.
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  • 文章类型: Case Reports
    骨软骨瘤是一种常见的良性原发性骨肿瘤,很少发生在肩胛骨。当它有症状时,建议手术切除。根据肿瘤的位置和大小,有多种手术切除方法可以使用。我们介绍了一个14岁的女性,她在骨科诊所看到右肩疼痛,由于肩胛骨上内侧骨软骨瘤引起的机械症状和内侧肩胛骨翼。采用了一种新颖的方法来切除肩胛骨上内侧腹面,取得了良好的临床效果。
    Osteochondromas are a common type of benign primary bone tumor rarely occurring in the scapula. When it is symptomatic, surgical removal is recommended. There are multiple approaches for surgical excision that can be used depending on the location and size of the tumor. We present a case of a 14-year-old female who was seen in the orthopedic clinic with right shoulder pain, mechanical symptoms and medial scapular winging due to a superomedial osteochondroma of the scapula. A novel superior approach to the superomedial ventral surface of the scapula was utilized to excise the tumor with good clinical results.
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  • 文章类型: Case Reports
    胫骨远端的骨间部分是骨软骨瘤可能发生的区域之一。骨软骨瘤通常发生在成长中的儿童中,并通过其对腓骨的压力作用引起逐渐的踝关节畸形。我们介绍了6例胫骨远端骨间骨软骨瘤患者(5名男孩和1名女孩,中位年龄为13岁)。他们在病变的近端和远端通过围绕其纵轴的180腓骨截骨术进行治疗。所有患者均接受治疗,除一例发生腓骨截骨部位骨不连外,均无任何并发症。在最后的后续行动中,所有的病人都没有痛苦,无复发报告。已经描述了用于切除胫骨远端骨间骨软骨瘤的各种方法。有或没有腓骨截骨术,切除手术期间有或没有踝关节畸形的急性矫正。尽管如此,对于切除此类病变的最佳方法尚无共识。
    The interosseous part of the distal tibia is one of the regions in which osteochondroma can occur. Osteochondroma typically occurs among growing children and causes gradual ankle deformity by its pressure effect on the fibula. We presented six patients (Five boys and one girl with median age of 13 years old) with distal tibial interosseous osteochondroma. They were treated by a 180̊ fibular osteotomy around its longitudinal axis just proximal and distal to the lesion. All patients were treated without any complication except for one who developed non-union of the site of the fibular osteotomy. In the last follow-up, all the patients were pain-free, and no recurrence was reported. Various methods have been described for resecting interosseous osteochondroma of the distal tibia, with or without fibular osteotomy and with or without acute correction of ankle deformity during resection surgery. Still, there is no consensus over the best method for resecting such lesions.
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  • 文章类型: Case Reports
    骨软骨瘤(OC)是良性骨肿瘤,其特征在于它们的生长带有软骨帽,通常发生在长骨的末端。它们在头部和颈部区域的发生很少,仅占头颈部肿瘤的1%左右。值得注意的是,下颌冠突和下颌髁突是报告OC的主要部位。患者经常表现出面部不对称,开口有限,和错牙合。根据病情,可能的治疗选择包括部分或全部髁切除术,垂直支截骨术,和辅助正颌手术。局部切除后,复发率低于1%-2%。在这个案例报告中,我们在一名27岁妇女中提出了一个独特的OC案例。它涉及到下颌髁突,导致在打开和关闭她的嘴时左侧的嘴偏离。本文的目的是详细介绍临床和影像学特征,组织病理学方面,以及治疗策略和区分潜在的诊断,对于这样的OCs。
    Osteochondromas (OCs) are benign bone tumors characterized by their growth with a cartilage cap and typically occurring at the ends of long bones. Their occurrence in the head and neck region is infrequent, accounting for only around 1% of head and neck tumors. Notably, the mandibular coronoid process and the mandibular condyle are the primary sites where an OC is reported. Patients often exhibit facial asymmetry, limited mouth opening, and malocclusion. Possible treatment options depending on the condition include partial or total condylectomy, vertical ramus osteotomy, and supplementary orthognathic surgery. The recurrence rate of under 1%- 2% is reported after local resection.  In this case report, we present a unique case of an OC in a 27-year-old woman. It involved the mandibular condyle, resulting in a left-sided mouth deviation while opening and closing her mouth. The purpose of this article is to detail the clinical and radiographic features, histopathological aspects, and treatment strategies and differentiate potential diagnoses, for such OCs.
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  • 文章类型: Case Reports
    在处理患有单发骨软骨瘤的儿童时,最明智的行动包括警惕观察和定期随访,考虑到自发解决的潜力。
    儿童最常见的良性软骨瘤是骨软骨瘤,当生长板在骨骼发育过程中突出时发展。治疗取决于症状,无症状病例需要监测,有症状患者需要手术干预。很少,无症状的骨软骨瘤可能会自发消失。我们报告了一名3岁男性在踢足球时因外伤而出现左臂肿胀和疼痛的情况。X线显示肱骨近端后外侧无骨软骨瘤。经过6个月的观察,该男孩耐受活动并且没有疼痛。五年后,骨软骨瘤在临床和放射学上均得到自发解决.我们的研究表明,由于自发消退的可能性,对骨软骨瘤儿童患者的年度观察比手术干预更有效。
    UNASSIGNED: In managing a child with a solitary osteochondroma, the most advisable course of action involves vigilant observation and regular follow-up, given the potential for spontaneous resolution.
    UNASSIGNED: The most frequent benign cartilage tumors in children are osteochondromas, which develop when the growth plate herniates during bone development. Treatment depends on the symptoms, with asymptomatic cases requiring monitoring and symptomatic patients requiring surgical intervention. Rarely, an asymptomatic osteochondroma may spontaneously disappear. We report the case of a 3-year-old male who presented with left arm swelling and pain due to trauma while playing football. X-rays revealed a proximal humerus posterolateral sessile osteochondroma. After 6 months of observation, the boy tolerated activity and had no pain. Five years later, the osteochondroma was resolved spontaneously both clinically and radiologically. Our study suggests that annual observation of child patients with osteochondroma is more effective than surgical intervention due to the possibility of spontaneous resolution.
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  • 文章类型: Case Reports
    骨软骨瘤(OC)是由透明软骨覆盖的软骨和髓质骨组成的骨病变。骨phy生长板软骨分离产生OCs,穿过骨膜骨袖.它们通常在长骨的干phy端表现为带蒂或无蒂肿块,是最常见的良性骨肿瘤。虽然在肩胛骨很少见,OCs可以在那里发生。骨折可能会引起症状,骨异常,或者潜在的恶性转化,特别是在遗传性多发性外生骨(HME)的存在。孤立性病变的恶性转化率估计为1%,而在遗传性多发性OCs中,它可以达到3-5%。我们报告了一例10岁的女性,她的右肩胛骨后部逐渐肿胀。在过去两年的过程中观察到这种逐渐增长并伴有轻度疼痛。疼痛是间歇性的,不影响她的日常活动。在检查中,一个硬,tender,在右肩胛骨上发现约2×2cm的非活动肿胀。患者的肩部和肩胸区域的活动范围正常。总之,由于孤立的肩胛骨OCs极为罕见,当与HME相关联时,它们是相当常见的。这项研究旨在提高对OC异常位点的认识。此外,我们已经全面介绍了我们对该患者进行的手术治疗,以帮助未来可能遇到类似疾病的外科医生。
    Osteochondromas (OCs) are bone lesions composed of cartilaginous and medullary bone capped with hyaline cartilage. OCs result from the separation of epiphyseal growth plate cartilage, pushing through the periosteal bone cuff. They commonly appear as pedunculated or sessile masses in the metaphysis of long bones and are the most common benign bone tumors. While rare in the scapula, OCs can occur there. Symptoms may arise from fractures, osseous abnormalities, or potential malignant transformation, especially in the presence of hereditary multiple exostoses (HME). The estimated rate of malignant transformation in solitary lesions is 1%, whereas in hereditary multiple OCs, it can reach up to 3-5%. We report a case of a 10-year-old female who presented with a gradually progressive swelling on the back of her right scapula. This progressive growth has been observed over the course of the past two years accompanied by mild pain. The pain was intermittent and did not affect her daily activities. On examination, a hard, tender, non-mobile swelling of approximately 2 × 2 cm was found over the right scapula. The patient had a normal range of motion in the shoulder and scapulothoracic regions. In conclusion, since solitary scapular OCs are extremely rare, they are quite common when associated with HME. This study aimed to increase awareness of the unusual site of OCs. Furthermore, we have included a full account of the surgical therapy we administered to this patient in order to assist future surgeons who may come across similar conditions.
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