Masui F, Ushigome S, Kamitani K, Asanuma K, Fujii K
Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan.
Eur J Surg Oncol. 2002 Dec;28(8):869-74. doi: 10.1053/ejso.2002.1276.
Chondroblastoma is an infrequent and unique neoplasm that is histologically characterized by chondroblastoma cells, osteoclast-like giant cells and sometimes reactive osteoid. Although it is generally regarded as benign, it may recur and sporadically metastasize to the lung. Many important questions concerning the prognostic factors and adequate surgical treatment of chondroblastoma have not been fully answered and remain controversial. The purpose of this study was to determine clinicopathological features useful in prediction of the tumour behaviours.
Eleven chondroblastoma cases were reviwed clinicopathologically. According to Enneking's radiographic grading system, seven cases were classified as stage I, three cases as stage II and one case was classified as stage III.
Nine cases had initially been treated with simple curettage, one had aggressive curettage applied as a primary surgery and one underwent amputation. Among the nine simple curettage cases, one recurred and was reoperated with aggressive curettage. Adjuvant treatment (alcohol and/or cement) was applied in the two aggressive curettage cases; none demonstrated further tumour recurrence. All lesions were curettaged, and one case recurred. The rate of proliferating-cell nuclear antigen expression was significantly higher in the recurrent case.
The recurrent case seemed to have a high growth activity. Simple curettage was effective for local control during the initial treatment in most cases, but aggressive curettage and adjuvant treatment with alcohol and/or cement was useful for local control in recurrent chondroblastoma and chondroblastoma presenting with an aggressive behaviour.
软骨母细胞瘤是一种罕见且独特的肿瘤，其组织学特征为软骨母细胞瘤细胞、破骨细胞样巨细胞，有时还有反应性类骨质。尽管它通常被认为是良性的，但可能会复发并偶尔转移至肺部。许多关于软骨母细胞瘤预后因素及适当手术治疗的重要问题尚未得到充分解答，仍存在争议。本研究的目的是确定有助于预测肿瘤行为的临床病理特征。
对11例软骨母细胞瘤病例进行临床病理回顾。根据恩neking的影像学分级系统，7例被分类为I期，3例为II期，1例为III期。
9例最初接受了单纯刮除术，1例初次手术采用了扩大刮除术，1例接受了截肢术。在9例单纯刮除术病例中，1例复发并再次接受扩大刮除术。2例扩大刮除术病例应用了辅助治疗（酒精和/或骨水泥）；均未出现进一步的肿瘤复发。所有病变均被刮除，1例复发。复发病例中增殖细胞核抗原表达率显著更高。
复发病例似乎具有较高的生长活性。单纯刮除术在大多数病例的初始治疗中对局部控制有效，但扩大刮除术以及酒精和/或骨水泥辅助治疗对复发性软骨母细胞瘤和表现为侵袭性行为的软骨母细胞瘤的局部控制有效。
