Dujardin F, Bocquet G, Debled M, Cambon-Michot C, Vera P, Patricot B, Thomine J M
Département de Chirurgie Orthopédique et Traumatologique, Hôpital Charles Nicolle, 76031 Rouen Cedex, France.
Rev Chir Orthop Reparatrice Appar Mot. 2000 May;86(3):293-9.
We report a case of primary intraosseous pleiomorphic rhabdomyosarcoma located in the pelvis of a 21-year-old woman followed for 4 years. The lytic tumor involved the acetabulum and the isthma with moderate extension to soft tissue. First line chemotherapy was unable to arrest tumor progression. Hemipelvectomy with saddle prosthesis reconstruction was performed, but septic complications dictated a secondary inter-ilio-abdominal amputation. Recurrence-free remission was achieved for 4 years, suggesting this was indeed a primary tumor. Primary intraosseous rhabdomyosarcomas are exceptional. Bone localizations generally suggest metastasis from a primary tumor often situated in an intraperitoneal localization. When search for a primary tumor is negative, intraosseous lesions can be considered as primary tumors warranting curative treatment. Radical surgical resection is recommended within the framework of a multidiscipinary management protocol associating radiotherapy and chemotherapy to improve prognosis.
我们报告一例原发性骨内多形性横纹肌肉瘤,位于一名21岁女性的骨盆,随访4年。溶骨性肿瘤累及髋臼和峡部,并中度延伸至软组织。一线化疗未能阻止肿瘤进展。进行了半骨盆切除术及鞍形假体重建,但感染并发症导致二次髂腹间截肢。实现了4年的无复发生存,提示这确实是原发性肿瘤。原发性骨内横纹肌肉瘤很罕见。骨内定位通常提示来自常位于腹膜内的原发性肿瘤的转移。当原发性肿瘤搜索为阴性时,骨内病变可被视为需要根治性治疗的原发性肿瘤。在将放疗和化疗相结合的多学科管理方案框架内,建议进行根治性手术切除以改善预后。