Normocholesterolemic Intra Osseous Xanthoma with Pathologic Fracture of Femur -A Case Report -

股骨幹黃色瘤合併病理性骨折—病例報告—

林鴻章(Hung-Chang Lin) ； 吳輝秋(Hway-Chiu Wu) ； 潘漢生(Han-San Pan)

《Journal of Orthopaedic Surgery Taiwan》 1卷3期 (1984/09) Pp. 108-112

摘要

本文報告一位九歲男童，於遊戲時不慎跌倒，造成右股骨幹病理性骨折。查其病史，於骨折前並無任何症狀與徵候，且無家族性高脂症。
經急診室放射學檢查，發現右股下3公之1處骨折。骨折處有一約4 × 4 × 1公分大小界限明顯之透光區域。全身骨骼X光檢查均無其他異常發現。經手術括除腫瘤及鋼板內固定後，經追蹤檢查顯示斷肢癒合良好。
病理學檢查發現有圓細胞及纖維母細胞浸潤現象，其間並有數個巨大細胞及由膽固醇所堆積所產生的空泡細胞。經證實為黃色瘤。
文獻所報告的骨內黃色瘤，皆顧成人發生，且與高血脂症有關，而本例為一小孩，亦無家族性高血脂症。雖全世界文獻上記載有20多例骨內黃色瘤之病例報告，而本例發生顧小孩之正常膽固醇的骨內黃色瘤合併理性骨折尤為罕見，故提出報告。

並列摘要

A rare case of normocholesterolemic xanthoma with pathologic fracture of femur in a 9-year-old boy was reported. The history revealed no subjective complaints or objective findings prior to the accident. Radiographic examination showed a well demarcated, round radioucent aea measured 4×4×1cm in size over the fracture ends. The family history was unremarkable and all the laboratory examinations were within normal limits. The specimen of pale yellowish friable material about 2 gm in weight wasremoved from the fracture ends. A plate and screws were applied for reduction and fixation of the fracture. Microscopic examination showed evidence of round cell, fibroblast infiltration with numerous giant cells and foam cells that contained cholesterol material. The diagnosis of intraosseous xanthoma was made. In review of literature, osseous xanthoma has often been associated with familial hyperlipemia (hyperglyceridemia and hypercholesterolemia), and almost always happened in adults. Only about 20 cases can be traced in the literature. Complicated by pathologic fracture at the fracture site in a child of normocholesterolemia has never been reported yet.

並列關鍵字

xanthoma ； normocholesterolemic