第1中手骨に発生した骨巨細胞腫の1例

Giant Cell Tumor of the First Metacarpal Bone : Case Report and Review of the Literature

　抄録：第1中手骨に発生した骨巨細胞腫の1例を経験したので報告する．症例は17歳，男性．右第1中手骨の腫脹と疼痛を認め，単純X線像で第1中手骨近位部に骨皮質の菲薄化・膨瘤を伴う骨透亮像を認めた．MRIでは骨破壊像および骨外病巣は認めず，掻爬・骨移植術を行った．手足発生の骨巨細胞腫は若年発生例が多く，多中心性の報告も散見される．また，腫瘍の活動性が高く，広範切除例の報告が多いが，自験例は骨外病巣を認めず，掻爬術を行った．術後14カ月で，再発・転移は認めないが，今後も厳重な経過観察が必要と思われる．

　We report a rare case of giant cell tumor (GCT) arising from the first metacarpal bone of a 17-year-old boy. The patient presented with thenar pain and swelling in the right hand. Radiographs showed a radiolucent expansive lesion on the first metacarpal bone, but there was no evidence of periosteal reaction or bone destruction. MRI confirmed the absence of soft tissue extension by the tumor. Curettage followed by bone grafting was performed, and the histological diagnosis was GCT. GCT of short bones predominantly occurs in the younger age group, and it is characterized by more aggressive behavior and a higher rate of multicentricity than long-bone GCT. Because of the aggressive behavior of short-bone GCT the treatment of choice is usually wide resection. Our patient had no evidence of multicentric lesions, recurrence, or metastaseis as of 14months after surgery.