Accadbled F, Brouchet A, Salmeron F, Darodes P, Cahuzac J P, Sales De Gauzy J
Service de Chirurgie Orthopédique, Traumatologique et Plastique, Hôpital des enfants, 330, avenue de Grande-Bretagne, 31026 Toulouse Cedex 3.
Rev Chir Orthop Reparatrice Appar Mot. 2001 Nov;87(7):718-23.
Chondroblastoma is a rare benign bone tumor. Treatment currently consists of curettage and bone graft. Prognosis depends basically on a relatively high rate of recurrence, between 5 and 38%, sometimes with local seeding of soft tissues and joint space. Such recurrences require wide resection with arthrodesis or even amputation. A 13-year-old girl with a humeral head chondroblastoma as treated by curettage and iliac bone graft. Six months later, a recurrence occurred with extension into the rotator cuff and the metaphysis. Remission was achieved by extensive surgical resection and hemiarthroplasty. The second case was a 14-year-old boy with a chondroblastoma of the right talus. He was treated by curettage and packing with bone substitute. After 2 recurrences with soft tissue and intra-articular extension, we performed a wide resection with reconstruction using a vascularized fibular graft. Many other cases in the literature illustrate such complications. We tried to find factors predictive of recurrence. Recurrence is observed when curettage was incomplete or when tumor cells were disseminated during surgery. Chondroblastoma is a benign bone tumor, but prognosis depends on the rapidity and severity of recurrence. Curettage should be as complete as possible and care should be taken to avoid contaminating the operative field.
软骨母细胞瘤是一种罕见的良性骨肿瘤。目前的治疗方法包括刮除术和骨移植。预后基本上取决于相对较高的复发率，在5%至38%之间，有时会出现软组织和关节间隙的局部播散。这种复发需要进行广泛切除并结合关节融合术甚至截肢。一名13岁女孩患有肱骨头软骨母细胞瘤，接受了刮除术和髂骨移植治疗。六个月后，复发并累及肩袖和干骺端。通过广泛的手术切除和半关节置换术实现了缓解。第二例是一名14岁男孩，患有右距骨软骨母细胞瘤。他接受了刮除术并用骨替代物填充。在出现两次伴有软组织和关节内播散的复发后，我们进行了广泛切除，并使用带血管蒂腓骨移植进行重建。文献中的许多其他病例也说明了此类并发症。我们试图找出预测复发的因素。当刮除不完全或手术过程中肿瘤细胞播散时会观察到复发。软骨母细胞瘤是一种良性骨肿瘤，但预后取决于复发的速度和严重程度。刮除应尽可能彻底，并注意避免污染手术野。
