Ollier病1例

1　病例资料患者 ,男 ,2 0岁。右下肢跛行 15年伴疼痛 2 0天就诊。患者两岁半开始摇摆式行走 ,智力发育正常。因不影响玩耍未引起注意。 16岁以后一直参加体力劳动。 2 0天前无明显诱因下出现右髋痛伴活动障碍 ,于 1998年 1月入院治疗。查体 :身高 15 6ｃｍ ,发育欠佳 ,营养可 ,全身皮肤黏膜未见血管瘤及血管怒张。漏斗胸畸形。腰椎轻度左凸畸形 ,以Ｌ5为重。双髋部软组织肥厚增宽 ,臀部后上方可触及坚硬包块 ,边界不清 ,右侧大转子上移 ,无压痛 ,被动活动髋关节有弹响并疼痛。Ｔｅｌｅ ｓｃｏｐｉｎｇ( + )、蛙式试验 ( + )。左髋关节前屈…     

骨延长术治疗Ollier病所致儿童肢体短缩并文献复习

[目的]分析骨延长术治疗Ollier病所致儿童肢体短缩的临床疗效和技术要点。[方法]收集2011年6月～2017年6月收治的2例因Ollier病所致肢体短缩的患儿,通过应用骨延长技术行矫正治疗,上肢患儿应用Wagner外固定架延长肱骨8.5 cm,下肢患儿应用Orthofix外固定架延长股骨9 cm并矫正內翻成角畸形26°。[结果]2例患儿术后均获得随访,上肢患儿随访5年,下肢患儿随访2年,患肢功能和外观均获得明显改善,无严重并发症发生,术后1年Enneking肢体功能评分,上肢患儿97%,下肢患儿80%。[结论]骨延长技术是治疗Ollier病所致儿童肢体短缩的有效方法。     

儿童Blau综合征并Ollier病一例

1 病例介绍 患儿 男,3 岁8个月.2019 年5 月因皮疹2 个月、间断发热半月余入院.1 年前患儿因全身散在皮疹于外院就诊,给予外用药后皮疹消退(具体诊断不详);双足背肿胀1 年余,因不影响活动未就医诊治.本次入院后实验室检查显示超敏C 反应蛋白114.09 mg/L、红细胞沉降率50 mm/1 h,给予抗感染、...     

腹膜后Castleman病1例

患者,女,48岁。“发现肾肿物5d”收治入院。无腹痛、血尿等不适。体检：神清。精神叮．心肺部查体未及明湿异常。腹平软。无压痛及反跳痛,术及明显包块,肝脾肋下未及。双肾区叩击痛阴性。双输尿管走行区术及明显压痛。双下肢无水肿。病理征阴性。实验室检查血常规、肝、肾功能、电解质等均正常。尿细胞学检查3次均未见肿瘤细胞。B超检查报告左上腹后腹膜K低回声团,考虑占位,神经来源不完全除外（图1A）。双肾CT增强提示左肾需旁富血供占位（图113）。     

手术治疗Freiberg病1例

1914年Freiberg首先报告了6例第2跖骨头缺血性坏死,随后其他学者发现类似的病变也可发生于第3、4跖骨头。由于其基本病理改变是跖骨头关节软骨和骺软骨内骨化障碍的非炎症性疾病,故文献上一般称之为跖骨头骨软骨病,又名Freiberg病。笔者于2009年手术治疗Freiberg病1例,获得满意的效果,现报告如下。     

奥来(Ollier)病1例报告

多发性软骨瘤侵犯身体一侧肢体合并肢体畸形的称为奥来(Ollier)病。我科遇到1例,报告如下。 患儿男,9岁,3岁时发现右膝部逐渐增大变粗,不痛。近3年来同侧肢体有膝外翻畸形,下肢变短跛行,外踝及足外侧亦有相继隆起,无不适,逐渐加重。体查:心肺(-),右膝除外翻畸形外,关节功能屈曲正常,伸稍受限,浮髌试验(-)。外踝及足背外侧可触及骨性隆起,无压痛。化验血常规及肝肾功能正常。血沉27mm/第1h。血清碱性磷酸酶24.7金氏单位。血清钙、磷正常。X线表现,整个右下肢短缩弯曲变     

巨大股骨近端软骨肉瘤1例

1 病例资料 患者,女,44岁,因左大腿疼痛半个月于2011年6月入院.8年前无明显诱因出现左大腿肿块,偶感酸胀,后肿块进一步长大,经外院影像学检查显示左股骨肿瘤,行病灶清除术.术后复发,先后2次做病灶清除术.近1年来肿块日趋增大,致行走不便,无疼痛,半个月前无明显诱因出现左大腿酸痛,不能行走,自行口服曲马多缓释片止痛,疗效欠佳.     

腹膜后Castleman病1例

患者,男,51岁。主因左腰部间歇性疼痛50d入院。患者于50天前无明显诱因出现左腰部间歇性隐痛。查体:脉搏:68次/min,血压:130/90mmHg(1mmHg=0.133kPa)。常规查体及泌尿系查体检查无阳性体征。锁骨下及腹股沟区未触及肿大淋巴结。B超提示左肾门旁偏下低回声团块,内可见少许血流信号。CT检查提示左肾腹侧平肾门水平可见3cm×3cm肿物,平扫CT值35.8Hu,增强后见肿物明显强化。拟诊腹膜后占位。完善术前检查后,在全麻下行腹腔镜下左腹膜后肿瘤切除术。术中于肾蒂外侧可见一3cm×3cm圆形肿物,表面光滑,与肾、肾周脂肪、肾蒂血管无明显粘连。手术…     

Ollier 病继发软骨肉瘤一例

患者男,65岁.5岁始发现右手肿物,随年龄而增大,20岁后肿物停止生长.近半年来肿物明显增大,随后逐溃破,伴浆性液体渗出,于2007年10月来我院就诊,收住人院.     

阴囊鳞状细胞癌并Paget病1例

患者,男,97岁。因“阴囊干痒、破溃约6年,发现阴囊肿物半年”于2007年12月25日收入我院。患者约6年前无意中发现阴囊表面有3cm×2cm大小的皮肤质地变硬,表面干燥,有裂纹,如苔藓样,时有瘙痒感,无渗血、渗液,无疼痛等不适,搔抓后局部易破溃。到当地医院就诊,考虑为“阴囊湿疹”,给予外用药物治疗,皮肤病变未得到控制,且病变面积不断扩大,逐渐累及整个阴囊。     

Open heart surgery of a patient with Basedow's disease: a case report

A case of open heart surgery of Basedow's disease was presented. A 46-year-old female was admitted for mitral regurgitation with heart failure. She suffered from Basedow's disease ten years ago, and was treated with MMI. With this treatment, her thyroid function became normal and did well over the last four years. When open heart surgery (MVR) was performed, examination of her thyroid gland revealed mild hypothyroidism, and the operation could be performed without any thyroidal trouble. We conclude, in case of heart disease with Basedow's disease, the operation can be performed without any thyroidal trouble if the thyroid function is controlled well to euthyroid for a long term. Euthyroid condition lasted 4 years in this case.     

Corticotroph cell hyperplasia in a patient with addison disease: Case report

A woman with Addison disease developed hyperpigmentation, headache, and nausea despite conventional replacement therapy with cortisone. Excessively elevated plasma adrenocorticotropic hormone (ACTH) with absence of response to administration of corticotropin-releasing factor (CRF), and roentgenological evidence of enlargement of the sella turcica, as well as detection of enlarged pituitary gland on magnetic resonance images, led to a diagnosis of ACTH-producing microadenoma, which was removed by transsphenoidal microsurgery. The specimen obtained at surgery evidenced corticotroph hyperplasia, as demonstrated by immunohistochemical staining for ACTH. Fine structure exhibited densely granulated cells with a few bundles of microfilaments and an abundance of large lysosomal bodies. Surgical removal of the hyperplasia alleviated the patient's symptoms, and hyperpigmentation faded remarkably. Her plasma ACTH level returned to normal, has remained normal for more than 3 years, and responds adequately to CRF administration.     

Poorly differentiated jejunal adenocarcinoma in a patient with coeliac disease: a case report

It is well known that coeliac disease increases the risk of gastrointestinal lymphomas, whereas adenocarcinoma is a rare complication. The authors report a case of a poorly differentiated jejunal adenocarcinoma complicating coeliac disease in a 40-year-old female and discuss the clinical, diagnostic and therapeutic aspects.     

Locking of the thumb in a patient with de Quervain's disease: a case report

We report a patient with a locked left thumb in association with de Quervain's disease. While bathing her baby 1 month after giving birth a 32-year-old woman suddenly noticed that she could not radially abduct her left thumb. Magnetic resonance imaging showed thickening of the abductor pollicis longus tendon with a heterogeneous signal intensity on T2-weighted images. Bandage fixation for 4 weeks did not improve her thumb movement, and she was subsequently treated by surgery. Operative findings revealed inhibition of the tendon gliding proximally as a result of nodule formation in the abductor pollicis longus tendon distal to the first dorsal compartment. This condition, locking of the thumb, was improved by excising the extensor retinaculum of the first dorsal compartment and tenosynovium around the abductor pollicis longus and extensor pollicis brevis tendon. At the 1-year follow-up examination the patient had no limitations or pain during active radial abduction of the left thumb.