Müller P E, Dürr H R, Wegener B, Pellengahr C, Maier M, Jansson V
Department of Orthopaedics, Universität Rostock, Ulmenstr. 44/45, 18055 Rostock, Germany.
Acta Orthop Belg. 2003 Apr;69(2):112-8.
Enchondromas are benign cartilaginous tumours and rarely transform into chondrosarcomas. Curettage is usually performed, and a low rate of complications is assumed. We analysed retrospectively data from 73 patients with enchondromas treated by curettage with respect to symptoms, therapy, complications and recurrences. All patients were treated by curettage of the tumour, in most cases followed by cancellous bone grafting. Twenty-three percent of the patients presented a complication. There were two recurrences but no malignant transformations in the follow-up period. During the same time period 29 patients with chondrosarcomas were treated, including two secondary chondrosarcomas. One had a recurrence of a benign enchondroma of the metacarpal and developed a pulmonary metastasis from a chondrosarcoma. The other was a patient with Ollier's disease who had a secondary chondrosarcoma of the radius. Malignant transformation of a solitary enchondroma to a chondrosarcoma is rare. On the other hand the complication rate of enchondroma curettage is considerable. Regular radiological follow-up of asymptomatic enchondromas may therefore be the better option.
内生软骨瘤是良性软骨肿瘤，很少转变为软骨肉瘤。通常采用刮除术，并发症发生率较低。我们回顾性分析了73例行刮除术治疗的内生软骨瘤患者的症状、治疗、并发症及复发情况。所有患者均接受肿瘤刮除术，多数病例术后进行松质骨移植。23%的患者出现并发症。随访期间有2例复发，但无恶变。同一时期，29例软骨肉瘤患者接受了治疗，其中包括2例继发性软骨肉瘤。1例患者掌骨良性内生软骨瘤复发并发生软骨肉瘤肺转移。另1例是患有Ollier病的患者，其桡骨发生继发性软骨肉瘤。孤立性内生软骨瘤恶变成为软骨肉瘤较为罕见。另一方面，内生软骨瘤刮除术的并发症发生率较高。因此，对无症状内生软骨瘤进行定期影像学随访可能是更好的选择。
