Abstract
Destructive changes in the bones are rarely observed in daily practice of pediatric orthopedic surgeons. Clinical and X-ray signs of destructive changes in the bone tissue are characteristic of tumoral, infectious, and inflammatory damages of bones. These signs do not always correspond to a specific disease, and differential diagnostics without histological evaluation is difficult. This is especially true for tumors of the sternum, 85% of which are malignant.
 Two rare clinical cases of primary malignant sternal neoplastic lesions in pediatric patients, and a detailed analysis of their clinical, radiologic, and morphologic data are presented. The importance of early histological verification for determining the choice of treatment is demonstrated. A short literature review is also presented.
Highlights
Деструктивные поражения осевого скелета встречаются относительно редко в повседневной практике детского травматолога-ортопеда
Destructive changes in the bones are rarely observed in daily practice of pediatric orthopedic surgeons
Clinical and X-ray signs of destructive changes in the bone tissue are characteristic of tumoral, infectious, and inflammatory damages of bones. These signs do not always correspond to a specific disease, and differential diagnostics without histological evaluation is difficult. This is especially true for tumors of the sternum, 85% of which are malignant
Summary
Destructive changes in the bones are rarely observed in daily practice of pediatric orthopedic surgeons. Clinical and X-ray signs of destructive changes in the bone tissue are characteristic of tumoral, infectious, and inflammatory damages of bones These signs do not always correspond to a specific disease, and differential diagnostics without histological evaluation is difficult. Клиническое наблюдение No 1 Больная П., 17 лет, поступила в клинику c жалобами на безболезненное уплотнение в области грудины. Поводом к направлению пациентки в СПбНИИФ стало подозрение на туберкулезный остит тела грудины, высказанное на основании результатов компьютерной томографии грудной клетки, на которой выявлена деструктивная полость размером. При операции (30.06.2015) выявлена костная полость со склерозированными краями размером 30 × 15 мм, занимающая всю толщину кости, располагающаяся слева от центральной линии в нижней части тела грудины, заполненная бурой грануляционно-некротической тканью. По данным гистологического исследования операционного материала заподозрена хондросаркома грудины, диагноз подтвержден при пересмотре онкоморфологами. Клиническое наблюдение No 2 Больная Г., 12 лет, поступила в клинику с жалобами на опухолевидное образование с гнойным
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