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| Abstract |
We herein report the case of a 15-year-old boy with cystic lesion of the capitate. Magnetic resonance imaging showed that the lesion demonstrated homogenous low-intensity on Tl-weighted imaging and ho...mogenous high intensity on T2-weighted imaging. The lesion was treated by curettage and autologous bone-grafting. The histological specimen from the cystic wall showed loose fibrous tissue with capillary vessels and extravasated red blood cells. The cystic lesion was filled with blood, suggesting that the cystic lesion was actually an aneurysmal bone cyst. The present case is the second reported case of aneurysmal bone cyst of the capitate. No recurrence has been observed during the 4 years since operation. We also review the literature related to ABCs of the hand with special emphasis on local recurrence.
動脈瘤様骨嚢腫(Aneurysmal bone cyst:ABC)は, 血液を含む骨嚢胞性病変であり, その成因は不明である. ABCは長管骨に多くみられ手根骨発生は稀である. 症例は15歳男性, 主訴は右手関節痛. 単純レントゲンにて有頭骨に辺縁骨硬化を伴う骨透亮像を認めた. MRIにて内部均一なT1強調一低信号, T2強調一高信号の嚢胞性病変を認めた. この病変に対して掻爬・自家骨移植術を施行した. 肉眼的に病変は血液を含む嚢胞性病変であった. 病理学的に嚢胞壁は線維性組織よりなり, 微小血管, 血管外赤血球を認め, 慢性炎症細胞出現は乏しかった. 臨床病理学的所見よりABCの診断であった. 術後4年の経過にて再発は見られていない. 文献的に有頭骨発生ABCは本症例が2例目であり, 有頭骨を含む手根骨発生(非長管骨)は本症例を含め7例の報告がある. 長管骨発生ABCの再発率は高いが, 手根骨発生ABCの再発の報告はなく, ABCの発生部位特異的な臨床所見の違いが考察された.show more
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