成人股骨巨细胞瘤切除术和植骨术中的保留方法:病例报告

Abdullah S. Alhazmi, Meshal Y. Altowairqi, Majd Saemaldahar, Abdulaziz A. Abdulaziz, Dhafer Almuffarh
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摘要

背景:巨细胞瘤(GCT)是一种良性骨肿瘤,具有局部侵袭性,可导致关节破坏或病理性骨折。在极少数情况下,它们会发展为肺转移和死亡。治疗巨细胞瘤的方法包括药物治疗、刮除术、冷冻疗法、切除和重建(包括关节成形术)。目的:本病例报告旨在讨论报告的 GCT 病例的替代治疗方案。病例报告:报告的病例显示,一名 25 岁的健康男性左髋关节疼痛持续了 6 个月。疼痛对生活方式的改变和药物治疗产生了抗药性。检查结果诊断为左股骨头 GCT。治疗包括术前服用地诺单抗、左髋关节脱位手术、病灶刮除、冲洗、植骨和骨水泥固定。我们的计划是一个很好的选择,因为它是一种低成本的手术,术后可以恢复到以前的活动水平,不受任何限制。该方案显示了极佳的疗效,但还需要更多的病例和长期随访来进一步研究。本病例报告旨在讨论报告的 GCT 病例的替代治疗方案。结论:股骨 GCT 尚缺乏标准的治疗方案。在本病例中,股骨头 GCT 患者接受了为期 6 个月的地诺单抗初始疗程治疗,随后进行了刮除、植骨和骨水泥填塞。结果表明,这种替代方法在功能上和放射学上都取得了可接受的效果。此外,该治疗方案简单且具有成本效益。
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Preserving Approach in Management of Femur Giant Cell Tumor with Curettage and Bone Grafting in an Adult Patient: Case Report
Background: Giant cell tumors (GCTs) are benign bone tumors that can be locally aggressive, leading to joint destruction or pathologic fractures. In rare cases, they can progress to lung metastasis and death. The management modalities of GCTs include medical treatment, curettage, cryotherapy, and resection and reconstruction, including arthroplasty. Objective: The current case report aimed to discuss alternative treatment options to the reported case of GCT. Case report: The reported case showed a healthy 25-years-old man with left hip joint pain progressing over six months. The pain was resistant to lifestyle modifications and medications. Investigations resulted in the diagnosis of a GCT in the left femur head. The management included a preoperative course of denosumab, surgical dislocation of the left hip, lesion curettage, irrigation, and bone graft and cementation. Our plan was a good alternative because it is a low-cost surgery that resulted in regaining the same previous level of activities without limitations. The plan showed excellent outcomes, but more cases and long-term follow-up are needed in further studies. The aim of the case report was to discuss alternative treatment options for the reported case of GCT. Conclusion: A criterion standard treatment option for GCT in the femur is lacking. In the current case, a GCT of the femoral head was treated with an initial course of denosumab for six months, followed by curettage, bone grafting and cementing packing. The outcome showed that this alternative modality yielded functionally and radiologically acceptable results. In addition, the treatment plan was simple and cost-effective.
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