胫腓骨大块骨溶解症一例报告

摘要：Objective Massive osteolysis is a rare disease characterized by progressive resorption of bones. This study aims to investigate the diagnosis and treatment of massive osteolysis, and to provide references for clinical diagnosis and therapy. Methods A typical case was reported. Etiology, clinical manifestations, imaging performance, pathology, diagnosis as well as therapy were summarized. Results Before the surgery, this patient was treated with diphosphate, calcium and vitamin D until osteolysis stopped and ossification occurred. No recurrence was observed 5 years postoperatively. Conclusions The etiology of massive osteolysis remains obscure. Traumatic history before its onset may be of significance. Massive osteolysis is characterized by an aggressive bone dissolution, whose clinical manifestations are non-specific. Malignancy signs appear in CT or MRI images, which may lead to missed diagnosis or misdiagnosis because of its contradictions to clinical manifestations and pathology. MRI enhanced imaging helps to identify. Multiple biopsies and sufficient sample size are beneficial for accurate pathologic diagnosis. The diagnosis of massive osteolysis need to combine clinical imaging results and pathology data. There are no effective methods in the treatment of massive osteolysis at present. Treatment principles mainly include the inhibition of bone resorption, prevention and control of complications. It is suggested that the combination of zoledronic acid, calcium and vitamin D can be applied to inhibit the bone dissolution. Surgery should be determined by limb functions. A multi-center clinical study on massive osteolysis is expected to further refine treatment strategies.