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Ewingâ’s耻骨肉瘤在儿童误诊为骨髓炎:一个案例报告

摘要

一个9岁的女孩与骨病变的左侧耻骨提出。临床症状和体征缓慢进展近一年，并在最近两个月变得更加明显。她入院时伴有左腹股沟疼痛肿胀，低度晚热，步态镇痛，炎症标志物增加。x线改变包括左耻骨的斑驳和蛀蛀的髓质，与“洋葱剥皮”骨膜反应有关。病变最初被临床、实验室和影像学检查误诊为骨髓炎。病人接受了抗生素治疗和固定术。一个月后临床表现明显改善，影像学检查显示髓质病变范围缩小。患者首次入院2个月后再次入院，临床症状严重恶化。症状包括剧烈疼痛、中度发热、伴有局部炎症和腹股沟淋巴结迹象的疼痛软组织肿块。肿块的组织学显示为坏死组织，而腹股沟淋巴结活检显示为瘤变。 A new bone biopsy indicated Ewing's sarcoma of the left pubis. The natural behavior of Ewing's sarcoma in the presented case demonstrated that it did not appear as an overwhelmingly aggressive tumor. The differential diagnosis from chronic osteomyelitis was further complicated by the marked remission of the clinical symptoms and signs and even the improvement of the radiographic findings following the antibiotic therapy

NK Sferopoulos

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