733個の遊離体を認めた肩関節滑膜骨軟骨腫症の1例

Osteochondromatosis in the Shoulder Joint with 733 Free Bodies. Case Report

　733個の遊離体を伴った滑膜骨軟骨腫症の1例を報告する．症例は20歳の男性で，症状は右肩甲部の重圧感のみで，自覚症状に乏しかった．健康診断時の胸部X線像で右肩甲部に多数の粒状石灰化陰影が発見された．CTでも右肩関節内，肩甲下滑液包内，上腕二頭筋長頭腱滑液包内に多数の粒状石灰化像を認め，滑膜骨軟骨腫症と診断し，遊離体摘出術を施行した．計733個，134gを摘出し，上腕二頭筋長頭腱滑液包からは滑膜と癒着した微小軟骨集積塊を切除した．組織学的には滑膜内に軟骨形成像を認めた．

　We report a case of osteochondromatosis of a shoulder joint in which 733 free bodies were identified. The patient was a 20-year-old man whose only symptom was dullness of the right shoulder. Chest X-rays during a routine medical checkup had revealed the free bodies. Computer tomography showed many calcified granules in the right shoulder joint, subscapularis bursa, and synovial sheath of the long head of the biceps brachii muscle. We made a diagnosis osteochondromatosis, and operated. A total of 733 bodies were counted, and their total weight was 134 g from synovial sheath of biceps, we excised a block which grouped osteochondoromatosis and adhered with bursa. Histological examination revealed cartilage formation with ossification in the synovium.