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Involución grasa sintomática de un simple quiste óseo en el húmero proximal: un informe de un caso raro
Arun Krishnamoorthi1, Silambarasi Nagasamy1
1Department of Orthopaedics, Parvathy Hospital, Chennai, Tamil Nadu, India.
Journal of orthopaedic case reports
|February 11, 2026
Resumen
La involución grasa de quistes óseos simples, rara en el húmero proximal, puede causar dolor en el hombro. Un nuevo enfoque quirúrgico que utiliza el curetaje y el injerto óseo trató eficazmente un caso sintomático, restaurando la función.
Área de la Ciencia:
- Cirugía Ortopédica en Cirugía Ortopédica.
- Oncología Musculoesquelética.
- Patología ósea Patología ósea.
Sus antecedentes:
- Los lipomas intraosseos y los quistes óseos simples son tumores mesenquimales con características compartidas y supuestos orígenes comunes.
- La involución grasa de quistes óseos simples es un hallazgo poco común, particularmente en el húmero proximal.
- Este caso pone de relieve las complejidades del diagnóstico y presenta una nueva estrategia quirúrgica para esta rara condición.
Objetivo del estudio:
- Informar de un caso sintomático de transformación de grasa en el húmero proximal.
- Para enfatizar los desafíos de diagnóstico asociados con esta rara entidad.
- Describir un nuevo enfoque de manejo quirúrgico para la involución grasa sintomática.
Principales métodos:
- Un hombre de 36 años con dolor progresivo en el hombro izquierdo presentó una lesión lítica humeral proximal.
- El paciente se sometió a un curetaje prolongado, a la colocación de bolas de cemento cargadas de antibióticos bioabsorbibles y a un injerto óseo autólogo.
- El examen histopatológico confirmó el tejido fibroadiposo indicativo de involución grasa.
Principales resultados:
- La recuperación postoperatoria fue rápida, y el paciente reanudó las actividades diarias en 2 semanas.
- Se observó una mejora funcional significativa, con puntuaciones de discapacidad del brazo, el hombro y la mano (DASH) que disminuyeron de 35 a 5 en 4 semanas.
- La histopatología confirmó el diagnóstico de involución grasa.
Conclusiones:
- El curetaje prolongado combinado con bolas de cemento cargadas de antibióticos bioabsorbibles y injerto óseo autólogo es un tratamiento viable para la involución grasa humeral proximal sintomática.
- Esta técnica quirúrgica asegura la eliminación completa de la lesión y el refuerzo estructural del hueso, lo que lleva a excelentes resultados funcionales.
- Las decisiones de tratamiento deben priorizar los síntomas del paciente sobre los hallazgos de la imagen por sí solos.
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