Melih GÜVEN, Murat ÇAKAR, CUMHUR İBRAHİM BAŞSORGUN, Barış KADIOĞLU, VOLKAN KILINÇOĞLU, Abdullah EREN

Kalsifik miyonekroz: Olgu sunumu

Kalsifik miyonekroz, ekstremite travmasının yıllar sonra görülebilen nadir bir komplikasyonudur. Genellikle alt ekstremitede kompartman sendromu ardından geç dönemde gelişen distrofik kalsifikasyon ile kendini gösteren bir patolojidir. Bu yazıda, ateşli silah yaralanmasını takiben sol uylukta kompartman sendromuna yönelik cerrahi girişimlerden 35 yıl sonra kalsifik miyonekroz gelişen 66 yaşında bir erkek hasta sunuldu. Hasta sol bacağında ağrı ve şişlik yakınmasıyla başvurdu. Muayenede, sol kruris orta hat anterolateralinde, eklemle ilişkisi olmayan, 20x8x6 cm boyutlarında, sınırları belirgin, hareketsiz yumuşak kıvamlı bir kitle görüldü. Radyografik incelemede sol kruriste çok sayıda lineer kalsifikasyon odağı saptandı; kemik patolojisi yoktu. Ameliyat sırasında tibia anterior kas kompartmanındaki tüm liflerin kalsifiye olduğu gözlendi. Kemik dokuya yapışıklık göstermeyen kitleye eksizyonel biyopsi uygulandı. Histopatolojik değerlendirme sonucu kalsifik miyonekroz ile uyumlu bulundu. Birinci yıl sonunda yapılan kontrolde semptomsuz olan hastada kitleye ait herhangi bir nüks görülmedi.

Anahtar Kelimeler:

Erkek, Tanı, ayırıcı, Nekroz, Yaralar, ateşli silah, Yaşlı, Bacak yaralanmaları, Kompartman sendromları, Kalsinoz, Kas hastalıkları, Uyluk

Calcific myonecrosis

Calcific myonecrosis is a rare complication of limb trauma, that may occur after many years. It is characterized by dystrophic calcification that develop in the late period following compartment syndrome usually in the lower limb. We present a 66-year-old man who developed calcific myonecrosis 35 years after surgical intervention for compartment syndrome secondary to a gunshot injury to the left thigh. He presented with pain and swelling in the left leg. On physical examination, there was a well-defined and immobile mass lesion in the anterolateral part of the left crus, soft in consistency and 20x8x6 cm in size, showing no relation with the joint. Radiographic evaluation showed linear calcifications in the left crus without osseous pathology. At surgery, all the fibers in the anterior tibial compartment were calcified and there was no attachment to the bone. The patient underwent an excisional biopsy. Histopathological evaluation of the specimens revealed calcific myonecrosis. At the end of one-year follow-up, the patient was symptomless, without any recurrence.

Keywords:

Male, Diagnosis, Differential, Necrosis, Wounds, Gunshot, Aged, Leg Injuries, Compartment Syndromes, Calcinosis, Muscular Diseases, Thigh,

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