Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the Literature

Introduction. Primary bone lymphoma (PBL) is a rare bone malignancy which may present with atraumatic pain, swelling, or pathological fracture. Whilst the femur is the most commonly affected site, any bone may be involved. PBL should be distinguished from other bone lesions to determine clinical man...

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Main Authors: Grace Kennedy, Phil Weir, Kevin Johnston, Patrick Elder
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2019/3174768
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author Grace Kennedy
Phil Weir
Kevin Johnston
Patrick Elder
author_facet Grace Kennedy
Phil Weir
Kevin Johnston
Patrick Elder
author_sort Grace Kennedy
collection DOAJ
description Introduction. Primary bone lymphoma (PBL) is a rare bone malignancy which may present with atraumatic pain, swelling, or pathological fracture. Whilst the femur is the most commonly affected site, any bone may be involved. PBL should be distinguished from other bone lesions to determine clinical management. Case Report. We report the case of an 89-year-old gentleman who presented to the local emergency department with atraumatic hip pain and inability to weight-bear. Multimodal imaging showed evidence of a tumor involving the proximal femur and adjacent acetabulum with an associated pathological intertrochanteric fracture. Biopsy specimens demonstrated this to be PBL of the diffuse large B-cell subtype. No other disease foci or nodal involvement was identified. The patient underwent proximal femoral replacement and acetabular reconstruction prior to commencing R-Mini-CHOP chemotherapy, during which time he has been permitted to fully weight-bear. Conclusion. To our knowledge, this is the first reported case of a patient having PBL with both femoral and acetabular involvements. Due to its infrequent occurrence, evidence remains limited to advise therapeutic guidelines. Our practice concurs with literature suggesting that surgery be reserved for cases of pathological fracture. However, the merits of undergoing surgical fixation prior to chemoradiation treatment have been considered.
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spelling doaj-art-3e63de20cf2e4f8fb03ba4658068d5f42025-08-20T02:08:22ZengWileyCase Reports in Orthopedics2090-67492090-67572019-01-01201910.1155/2019/31747683174768Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the LiteratureGrace Kennedy0Phil Weir1Kevin Johnston2Patrick Elder3Department of Haematology, Altnagelvin Area Hospital, Glenshane Road, Londonderry, Co. Londonderry, IrelandDepartment of Haematology, Altnagelvin Area Hospital, Glenshane Road, Londonderry, Co. Londonderry, IrelandDepartment of Haematology, Altnagelvin Area Hospital, Glenshane Road, Londonderry, Co. Londonderry, IrelandDepartment of Haematology, Altnagelvin Area Hospital, Glenshane Road, Londonderry, Co. Londonderry, IrelandIntroduction. Primary bone lymphoma (PBL) is a rare bone malignancy which may present with atraumatic pain, swelling, or pathological fracture. Whilst the femur is the most commonly affected site, any bone may be involved. PBL should be distinguished from other bone lesions to determine clinical management. Case Report. We report the case of an 89-year-old gentleman who presented to the local emergency department with atraumatic hip pain and inability to weight-bear. Multimodal imaging showed evidence of a tumor involving the proximal femur and adjacent acetabulum with an associated pathological intertrochanteric fracture. Biopsy specimens demonstrated this to be PBL of the diffuse large B-cell subtype. No other disease foci or nodal involvement was identified. The patient underwent proximal femoral replacement and acetabular reconstruction prior to commencing R-Mini-CHOP chemotherapy, during which time he has been permitted to fully weight-bear. Conclusion. To our knowledge, this is the first reported case of a patient having PBL with both femoral and acetabular involvements. Due to its infrequent occurrence, evidence remains limited to advise therapeutic guidelines. Our practice concurs with literature suggesting that surgery be reserved for cases of pathological fracture. However, the merits of undergoing surgical fixation prior to chemoradiation treatment have been considered.http://dx.doi.org/10.1155/2019/3174768
spellingShingle Grace Kennedy
Phil Weir
Kevin Johnston
Patrick Elder
Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the Literature
Case Reports in Orthopedics
title Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the Literature
title_full Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the Literature
title_fullStr Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the Literature
title_full_unstemmed Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the Literature
title_short Surgical Management of Primary Bone Lymphoma of the Hip: A Case Report and Review of the Literature
title_sort surgical management of primary bone lymphoma of the hip a case report and review of the literature
url http://dx.doi.org/10.1155/2019/3174768
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AT patrickelder surgicalmanagementofprimarybonelymphomaofthehipacasereportandreviewoftheliterature