Yu-Hsiang Sung1, Shan-Wei Yang2,3,4, Yih-Wen Tarng5, Shwu-Jen Chang6, Chien-Jen Hsu7, Lain-Chyr Hwang8. 1. Department of Orthopedics, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung City, Taiwan. yhsung@vghks.gov.tw. 2. Department of Orthopedics, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung City, Taiwan. yangshanwei@yahoo.com.tw. 3. Department of Biomedical Engineering, I-Shou University, Kaohsiung County, Taiwan. yangshanwei@yahoo.com.tw. 4. Department of Electrical Engineering, I-Shou University, Kaohsiung County, Taiwan. yangshanwei@yahoo.com.tw. 5. Department of Orthopedics, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung City, Taiwan. ywtarng@vghks.gov.tw. 6. Department of Biomedical Engineering, I-Shou University, Kaohsiung County, Taiwan. sjchang@isu.edu.tw. 7. Department of Orthopedics, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung City, Taiwan. cjhsu@vghks.gov.tw. 8. Department of Electrical Engineering, I-Shou University, Kaohsiung County, Taiwan. lchwang@isu.edu.tw.
Abstract
BACKGROUND: Leiomyoma is a benign tumor of smooth-muscle origin. They most commonly derived from the uterus. Besides, they were also usually diagnosed in the gastrointestinal tract, skin, and mucous membranes. However, it rarely occurs in the bone. CASE PRESENTATION: The authors reported one case of 56-year-old male with intraosseous leiomyoma of the distal femur. Initially, the patient felt left knee pain for 1 year. Radiographs film disclosed an ill-defined osteolytic lesion with thinning cortex over left distal femoral medial condylar region. Computed tomography (CT) revealed homogenous radiolucent lesion with thinning cortex over the metaphysis of distal femur. Magnetic resonance imaging showed focal marrow replacement by tumor. CT-guide biopsy was performed, and the pathology showed a picture of leiomyoma. Since the definite diagnosis, the lesion was treated with en-bloc resection and endoprosthetic knee joint reconstruction. Satisfied result and disease free were achieved during follow-up. CONCLUSIONS: Intraosseous leiomyoma of the extremities is difficult to be diagnosed due to extraordinarily rare. This rare benign tumor should be included in the differential diagnosis of any relatively intraosseous lesion with benign imaging findings. This is the first published case of primary intraosseous leiomyoma of distal femur after literature reviews.
BACKGROUND:Leiomyoma is a benign tumor of smooth-muscle origin. They most commonly derived from the uterus. Besides, they were also usually diagnosed in the gastrointestinal tract, skin, and mucous membranes. However, it rarely occurs in the bone. CASE PRESENTATION: The authors reported one case of 56-year-old male with intraosseous leiomyoma of the distal femur. Initially, the patient felt left knee pain for 1 year. Radiographs film disclosed an ill-defined osteolytic lesion with thinning cortex over left distal femoral medial condylar region. Computed tomography (CT) revealed homogenous radiolucent lesion with thinning cortex over the metaphysis of distal femur. Magnetic resonance imaging showed focal marrow replacement by tumor. CT-guide biopsy was performed, and the pathology showed a picture of leiomyoma. Since the definite diagnosis, the lesion was treated with en-bloc resection and endoprosthetic knee joint reconstruction. Satisfied result and disease free were achieved during follow-up. CONCLUSIONS:Intraosseous leiomyoma of the extremities is difficult to be diagnosed due to extraordinarily rare. This rare benign tumor should be included in the differential diagnosis of any relatively intraosseous lesion with benign imaging findings. This is the first published case of primary intraosseous leiomyoma of distal femur after literature reviews.
Authors: Bashir A Zikria; Miroslav R Radevic; Susan C Jormark; Andrew G Huvos; S Steven Yang Journal: J Bone Joint Surg Am Date: 2004-11 Impact factor: 5.284
Authors: A Vaillo-Vinagre; C Ballestin-Carcavilla; S Madero-Garcia; S Pastor Garcia; A Checa Garcia; F J Martinez-Tello Journal: Skeletal Radiol Date: 2000-03 Impact factor: 2.199
Authors: A M Loyola; N S Araújo; D Zanetta-Barbosa; V C Mendes; C Jordão-Silva; T O Bittar Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Endod Date: 1999-01