Schulte M, Sarkar M R, Von Baer A, Schultheiss M, Suger G, Hartwig E
Abteilung für Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Universität Ulm.
Unfallchirurg. 2000 Feb;103(2):115-21. doi: 10.1007/s001130050022.
The aneurysmal bone cyst represents a tumor-like lesion, which does not occur frequently. Every site of the skeleton may be involved. Although it can be observed at any age, it distinctly predominates from 10 to 20 years of age. Distinction of aneurysmatic bone cysts from certain benign or malignant bone tumours requires subtle imaging techniques and an experienced bone tumour pathologist. Since the lesion shows a heterogeneous biological behaviour and typically occurs in the growing skeleton, a wide range of surgical procedures must be provided concerning tumour resection and defect reconstruction. In the current retrospective study results of 41 surgically treated aneurysmal bone cysts, thereof 5 latent, 31 active, and 5 aggressive lesions, were investigated. While morbidity due to the therapeutic measures was comparatively low even in extended lesions and demanding reconstructions, a recurrence rate of 19.5% had to be observed in our series. Taking into consideration the biological activity of the lesion, analysis of the recurrences revealed inappropriate surgical margins had been chosen at the primary operation in all of these patients. Since the risk of a local relapse is linked both to aggressiveness of the primary lesion and to surgical radicality, therapy of aneurysmal bone cyst requires preoperative staging and stage-dependent surgical procedures.
动脉瘤样骨囊肿是一种较少见的肿瘤样病变。骨骼的各个部位均可受累。虽然任何年龄都可出现,但明显以10至20岁年龄段为主。将动脉瘤样骨囊肿与某些良性或恶性骨肿瘤区分开来需要精细的成像技术和经验丰富的骨肿瘤病理学家。由于该病变表现出异质性生物学行为且通常发生于生长中的骨骼,因此在肿瘤切除和缺损重建方面必须提供多种手术方法。在当前这项回顾性研究中,对41例接受手术治疗的动脉瘤样骨囊肿的结果进行了调查,其中5例为潜伏性病变,31例为活动性病变,5例为侵袭性病变。尽管即使在广泛病变和复杂重建的情况下,治疗措施导致的发病率相对较低,但在我们的系列研究中仍观察到复发率为19.5%。考虑到病变的生物学活性,对复发情况的分析显示,所有这些患者在初次手术时均选择了不恰当的手术切缘。由于局部复发的风险既与原发病变的侵袭性有关,也与手术的彻底性有关,因此动脉瘤样骨囊肿的治疗需要术前分期并根据分期采取相应的手术方法。