Chapter 881: 864 Bone on the Belly (Alliance Leader cws6682 Bonus Chapter 4)

Yu Jianshui was stunned for a moment, then immediately delighted.

At this point, as long as someone said it wasn't cancer metastasis, he would be willing to believe it. But when Zheng Lao Ban said it, it seemed to carry a bit more weight.

"Zheng Lao Ban, Zheng Lao Ban, what do you suspect it is?" Yu Jianshui asked anxiously.

"How pathetic." Su Yun looked at him with disdain and said.

"I'm considering heterotopic ossification." Zheng Ren said.

"Isn't heterotopic ossification usually found near large joints?" Su Yun frowned and asked.

Yu Jianshui had heard the term heterotopic ossification before, but that was just review before an exam. Since entering clinical practice, for a urology doctor, it's extremely rare… basically he never encounters heterotopic ossification.

He tried hard to recall what heterotopic ossification was.

"Didn't you just say it often occurs near large joints, like the hip or elbow? But there's a small chance it appears elsewhere, like in this patient right here." Zheng Ren shook the CT film in his hand, smiled, and said, "Don't worry, Yu Zong, it's fine."

Seeing Zheng Ren's confident statement, Yu Jianshui relaxed and gave a slight smile.

Heterotopic ossification refers to the appearance of osteoblasts in soft tissue, forming bone tissue. Recalling the definition, Yu Jianshui thought that if it were heterotopic ossification, many difficult points could be explained, such as the localized calcified lesions seen on CT.

But… a surgical wound, heterotopic ossification—however you hear it, it just sounds unreliable.

"Zheng Lao Ban, how does this heterotopic ossification form?" Yu Jianshui asked in a low voice.

"The triggering factors might be neural and bioelectric factors, but so far there's no definitive explanation." Zheng Ren said: "This change usually occurs near large joints, starting with redness, swelling, heat, and pain, and after ossification leads to joint movement impairment."

"In fibrous connective tissue, primitive cells proliferate actively accompanied by a rich capillary network, calcium salts deposit, forming bone. Mature heterotopic ossification has bone structure, with an outer layer wrapped in fibrous connective tissue, inside are osteoblasts, possessing trabecular and bone-like tissue, and the center is active primitive cells." Zheng Ren pointed at the film and said, "The image in the film exactly matches the definition of heterotopic ossification."

"Boss, saying all that is useless." Su Yun blew a breath, her black hair fluttering, "Just cut it out and do pathology, right?"

"No." Zheng Ren said firmly.

""

""

Su Yun and Yu Jianshui both were stunned for a moment.

Generally speaking, the gold standard for determining whether an abnormal proliferation is a malignant tumor is pathological diagnosis. If there is suspicion, a needle biopsy is performed and sent for pathological diagnosis.

This has already become a fixed mindset in clinical practice.

Why did Zheng Ren say no?

"Heterotopic ossification first appeared in large numbers during World War I, after which it was recognized. Blast injuries and spinal cord injuries were considered triggering factors, but later research showed this is only part of the cause."

"And urinary tract infection is also one of the triggering factors." Zheng Ren said: "The specific mechanism is still unclear, just speculation."

Su Yun sighed, looking at current medical science, many diseases have no definitive conclusion. In other words, everywhere is a damn minefield—you never know which step will blow you to pieces.

Heterotopic ossification is still relatively good; although ossification at the surgical wound is extremely rare, it won't cause patient death.

If it were a truly aggressive disease, like the malignant hyperthermia the boss encountered…

The more he thought about it, the more annoyed he felt. Su Yun sighed and said, "Boss, why do you increasingly not want to work?"

"Because you know more and have more exposure, so the unknown…"

"Enough, stop feeding me chicken soup." Su Yun raised her hand and said, "You still haven't said why we can't cut it."

"It's still in the ossification phase; if you cut it out now, it will grow again. You need to wait 9–12 months or until ossification matures and stabilizes before proceeding. Postoperatively, oral disodium etidronate for a year will do."

"At the cellular level?" Su Yun asked.

"Probably."

"Can you be a bit more reliable?"

"Research institutions have no consensus; I haven't seen any recognized useful material." Zheng Renye also felt helpless, putting the film away.

"Yu Zong, let Director Miao know." Zheng Ren said: "If it's nothing, I'll head out."

"Um…" Yu Jianshui hesitated, wanting to say something but feeling awkward.

"The film is already quite clear, don't worry." Zheng Ren knew what he was pondering, smiled, patted Yu Jianshui on the shoulder, and comforted him.

"It won't delay the condition, will it?" Yu Jianshui said softly.

"You don't understand what I'm saying." Su Yun displeased, retorted directly, "It's fine, it's fine, what's there to delay? Are you hoping it's a tumor?"

"Yun Ge'er…" Yu Jianshui quickly said, "This isn't something to be especially afraid of, is it?"

"No." Zheng Ren laughed, "You're overthinking because you care; if it were a patient from another department, or if you saw it in the outpatient clinic, I believe you could also give the correct diagnosis."

Having said that, Zheng Ren opened the door of the on-call room and walked out.

Yu Zong didn't leave; he fell silent for a moment, picked up his phone, and called Director Miao.

"Director, I just ran into Zheng Lao Ban and had him glance at the film."

"Mm-hmm, just happened to run into him."

"Zheng Lao Ban said it's heterotopic ossification."

"Oh, Director Chu also thinks so? Then good, then good."

"Alright, I'll talk more when you return." Yu Jianshui hung up the phone, staring at the film bag in a daze.

Zheng Lao Ban and Director Chu's opinions are consistent, so good, so good.

The patient's condition is recovering well, with no metastasis to other organs, and blood urea nitrogen and creatinine are not high.

Excluding metastatic seeding at the surgical wound, survival beyond five years is hopeful, even highly hopeful.

No problem, then it's good.

Yu Zong let out a breath; today he had scared himself enough. Yesterday the patient came for a follow-up, bringing the local film. Director Miao worried about resolution, so he had the patient come here for one.

From the surgery onward, Director Miao brought the patient for examinations, and I had been anxious the whole time; now I finally feel at ease.

It's fine, that's good.

However, he thought about finding time to invite Zheng Lao Ban for a meal to strengthen their relationship. "What can't I do?" he mused, still counting on Zheng Lao Ban to lend a hand next time.

This time doesn't count; regarding the incident of malignant hyperthermia encountered in the operating room, Yu Jianshui later inquired. According to Director Xu of the Anesthesiology Department, if Zheng Lao Ban weren't there, even if he led the rescue, it wouldn't have been so perfect.

Zheng Lao Ban is like someone who has personally experienced a successful rescue from malignant hyperthermia; afterward, everyone recalled and realized that Zheng Lao Ban indeed could stay busy without chaos. Every order was highly targeted.

People like this, it's better to stay on good terms with him.

Yu Jianshui secretly made up his mind.