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患者,女41岁。因左肩胛骨无任何诱因出现进行性肿块10年,左上肢发麻3个月,于1997年1月14日入院。查体:左肩高于右肩,左腋下饱满如挟物状 ,左肩胛骨背部高突。左肩关节功能活动轻度受限,肌力,感觉无异常,左侧桡动脉搏动正常,无压痛,左肩胛骨可随肩关节活动。X线片示:左肩胛骨呈菜花状,不规则,边界不清楚,形态完全改变(见图1)。CT片示:左肩胛骨巨大肿瘤,瘤与正常组织难以区分。肿瘤挤压胸廓内移。肿瘤边界不甚清楚。骨穿病理报告:骨软骨瘤。 于1997年1月21日全麻下行左肩胛骨骨软骨瘤切除术。术中发现肿瘤沿肩胛骨向腹,背侧膨大,直径约12cm。仅肩胛骨冈部有10×3.5cm~2大小的正常骨质。余皆为菜花状,外围被厚薄不均的软骨膜及帽覆盖。将肿瘤分段取下,保留肩胛骨盂。肿瘤重达1950克。术后病理报告为骨软骨瘤。术后X线片
The patient was 41 years old. The left upper limb was numb for 3 months because of no inducement of left scapula, and it was admitted to hospital on January 14, 1997. Physical examination: The left shoulder is higher than the right shoulder, and the left lower armpit is full of pimples. The back of the left shoulder blade is high in protrusion. The function of the left shoulder joint was mildly limited, muscle strength, and no abnormal feeling. The left iliac artery had normal beats and no tenderness. The left shoulder blade could move with the shoulder joint. X-ray film showed that the left shoulder blade was cauliflower-like, irregular, with unclear boundaries and completely altered morphology (see Figure 1). CT showed: a huge tumor of the left scapula, the tumor and the normal tissue is difficult to distinguish. The tumor squeezes the thorax inside. The boundary of the tumor is not clear. Osteoporosis report: Osteochondroma. On January 21, 1997, the left scapula osteochondroma was removed under general anesthesia. During surgery, the tumor was found along the scapula toward the abdomen, and the dorsal side was enlarged with a diameter of about 12 cm. Only the scapula occipital area has a normal bone mass of 10×3.5 cm-2. All of them are cauliflower-like, and the periphery is covered with unevenly thick cartilage and caps. Remove the tumor and retain the scapula. The tumor weighed 1950 grams. Postoperative pathology reports osteochondroma. Postoperative X-ray film