Synovial Chondromatosis on the Metacarpophalangeal Joint of the Hand-A Rare Case

手部掌指骨關節之滑膜軟骨瘤病變－一罕見個案報告

莊昆霖(Kun-Lin Chuang) ； 謝式洲(Shyh-Jou Shieh)

《臺灣整形外科醫學會雜誌》 19卷2期 (2010/06) Pp. 152-157

https://doi.org/10.7096/TJTSPS.201006.0152

摘要

背景：
滑膜軟骨瘤病變是一種良性的疾病，而滑膜增生與透明軟骨的化生病變為其特色。本病灶不常見於較小的關節，發生於手部亦為罕見。滑膜軟骨瘤病變與滑膜軟骨惡性腫瘤間的關係並不清楚。
目的及目標：
報告一罕見病例，並針對此進行文獻回顧。
材料及方法：
我們提出一例於2008年在成大醫院接受手術切除並予復健治療的病例，病患為55歲男性，其主訴為發現一年的左手背腫瘤，病灶會隨時間變大與有些微的壓痛。術前理學檢查與超音波檢查可知其源於第四指掌指骨關節處，及其有不同成分組成之特性。組織病理學確診為滑膜軟骨瘤病變。
結果：
病患於術後九個月的追蹤內沒有腫瘤復發的證據，而且保有良好的手部功能。
總結：
滑膜軟骨瘤病變轉為惡性的機率低；發生於手背掌指骨關節的案例很罕見。對於手部的病灶而言，手術切除與仔細保留相關的手部細緻結構，是治癒此病灶的方法。因為其局部復發率高，術後定期的追蹤是必要的。

並列摘要

Background:
Synovial chondromatosis is a benign lesion characterized by synovial proliferation and metaplastic change of hyaline cartilage. It usually occurs in large joints, but rarely in small joints of hands. Whether synovial chondromatosis will transform into chondrosarcoma and what the risk factors are that it will become malignant are unclear.
Aim and Objectives:
To report a rare case and to review literatures on this topic.
Materials and Methods:
A 55-year-old male patient suffered from a tumor on left dorsal hand for one year and was treated by surgical excision followed by rehabilitation at our hospital in 2008. The symptoms were size progression and mild tenderness. Preoperative sonography revealed heterogeneous characteristics and originated from the 4th metacarpophalangeal joint. The pathology report was consistent with the diagnosis of synovial chondromatosis.
Results:
The patient is free of recurrence at a 9-month follow up and has recovered good hand function.
Summary:
Based on literature review, synovial chondromatosis has a low risk of becoming malignant, and which involving the metacarpophalangeal joint of the hand is rare. Surgical excision and preservation of delicate structures of hand is the main treatment, and regular follow-up is necessary because of its relatively high recurrence rate.

並列關鍵字

synovial chondromatosis