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首页> 外文期刊>The Journal of hand surgery, European volume >Intraosseous glomus tumour in the distal phalanx of the index finger
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Intraosseous glomus tumour in the distal phalanx of the index finger

机译：食指远端指骨骨内球囊肿

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Dear Sir, Glomus tumour usually occurs in the soft tissue, but very rarely in the bone. We report a case of an intraosseous glomus tumour with severe pain at rest. A 30-year-old man presented with a 7 year history of progressive right index finger pain. The pain gradually increased in severity, occurring at night as well as at rest with marked tenderness over the distal phalanx. There was no swelling or erythema, the nail was not discoloured or deformed, but the affected area became so tender that the patient was preoccupied with the protection of his index finger from any contact. A radiograph revealed a well-circumscribed osteolytic lesion in the distal phalanx (Fig 1) without a sclerotic border and with normal dorsal or palmar cortices. MRI confirmed an intraosseous space-occupying lesion with low signal intensity on T1-weighted image and high signal intensity on T2-weighted images, with no extraosseous involvement. These findings suggested an intraosseous glomus tumour which was excised through a fish-mouth incision over the finger tip. Subcutaneous soft tissue on the palmar side of the distal phalanx was normal as was the surface of the distal phalanx (Fig 2). Through a window in the palmar cortex of the distal phalanx we curetted the lesion, and the residual defect was filled with artificial bone graft. Histopathology demonstrated prominent vascular structures with perivascular nests of glomus cells. At present, 6 months after surgery, the patient has no pain at rest or at night.
机译：亲爱的先生，Glomus肿瘤通常发生在软组织中，但很少发生在骨骼中。我们报告一例骨内球蛋白瘤，休息时剧烈疼痛。一名30岁的男性患者出现了进行性右手食指疼痛7年的病史。疼痛的严重程度逐渐增加，在夜间和休息时都发生，远侧指骨有明显的压痛。没有肿胀或红斑，指甲没有变色或变形，但是患处变得如此柔软，以至于患者全神贯注于保护他的食指不受任何接触。 X线片显示远端指骨有良好的溶骨性病变（图1），无硬化性边界，背侧或掌部皮质正常。 MRI证实为骨内占位性病变，在T1加权图像上信号强度低，在T2加权图像上信号强度高，没有骨外累及。这些发现提示骨内球囊肿肿瘤是通过指尖上方的鱼嘴切口切除的。指骨远端掌侧的皮下软组织正常，指骨远端表面也正常（图2）。通过远端指骨掌部皮质的窗口，刮除病灶，并用人造骨移植物填充残余缺损。组织病理学显示突出的血管结​​构以及球状细胞的血管周巢。目前，手术后六个月，患者在休息或夜间都没有疼痛。

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