Murray P M, Berger R A, Inwards C Y
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
J Hand Surg Am. 1999 Sep;24(5):1008-13. doi: 10.1053/jhsu.1999.1008.
Primary neoplasms of the carpal bones are rare. We found 44 primary tumors of the carpal bones of 26,800 bone neoplasms (prevalence, 0.16%). Original histologic slides and original radiographs were reviewed in 36 and 29 cases, respectively. Thirty-eight tumors (86%) were benign; 6 (14%) were malignant. The average patient age was 35 years. Benign lesions were diagnosed at a younger age (32 years) than malignant lesions (58 years). Benign tumors occurred more frequently in males (23 of 38 patients); the 6 malignant lesions were equally distributed by gender (3 males and 3 females; 95% confidence interval, 11.8-88.2). The most common tumor was osteoid osteoma (11 cases); the most common malignant neoplasm was hemangioendothelial sarcoma (3). The most common locations were the scaphoid (13 cases) and capitate (10), which together accounted for 52% of all neoplasms. Tumors were identified in every carpal bone except the trapezium. The diagnosis of tumor in a carpal bone should be considered in the undiagnosed painful wrist, especially in younger patients without imaging abnormalities.
腕骨原发性肿瘤较为罕见。在26800例骨肿瘤中，我们发现了44例腕骨原发性肿瘤（患病率为0.16%）。分别对36例和29例病例的原始组织学切片和原始X线片进行了回顾。38例肿瘤（86%）为良性；6例（14%）为恶性。患者的平均年龄为35岁。良性病变的诊断年龄（32岁）低于恶性病变（58岁）。良性肿瘤在男性中更为常见（38例患者中有23例）；6例恶性病变在性别上分布均匀（3例男性和3例女性；95%置信区间为11.8 - 88.2）。最常见的肿瘤是骨样骨瘤（11例）；最常见的恶性肿瘤是血管内皮肉瘤（3例）。最常见的部位是舟骨（13例）和头状骨（10例），两者共占所有肿瘤的52%。除大多角骨外，在每块腕骨中均发现了肿瘤。对于未确诊的腕部疼痛患者，尤其是无影像学异常的年轻患者，应考虑腕骨肿瘤的诊断。
