Leinung S, Schönfelder M, Würl P
Chirurgische Klinik II, Universität Leipzig.
Chirurg. 2004 Dec;75(12):1159-64. doi: 10.1007/s00104-004-0902-0.
Soft tissue sarcoma often goes undetected.
Over a 10-year period, the patients referred to us with a soft tissue tumor (STT) of the extremities and wall of the trunk were analyzed retrospectively. The aim of the present study was to investigate the differential diagnoses, the number of incompletely operated STS, and local recurrences together with their percentage fluctuations.
A total of 490 patients with an STT were referred to our department, and of these patients 55% were diagnosed with an STS. In addition to STS, the differential diagnoses for STT included 2% lymphomas, 18% isolated carcinoma metastases, 18% benign mesenchymal tumors, 5% inflammatory processes, and 2% old hematomas. Only 45% of the STS had not undergone previous surgery. Of these, 15% had been incompletely resected, while 39% of the STS patients were admitted with a local recurrence. Within the 10-year period, referrals with STT and STS remained relatively constant, but referrals of patients with incompletely resected or recurrent STS doubled in the last 2 years under observation.
In view of the numerous differential diagnoses of an STT, both the possibility of an STS and also carcinoma manifestations in the soft tissues should receive more attention. With the aim of reducing the relatively high number of STS re-resections and local recurrences, the treatment of patients with suspicious STT should be reserved for a specialized center.
软组织肉瘤常常难以被发现。
在10年期间,对转诊至我们科室的患有四肢及躯干壁软组织肿瘤(STT)的患者进行回顾性分析。本研究的目的是调查鉴别诊断、不完全手术切除的软组织肉瘤(STS)数量、局部复发情况及其百分比波动。
共有490例STT患者转诊至我们科室,其中55%被诊断为STS。除STS外,STT的鉴别诊断包括2%淋巴瘤、18%孤立性癌转移、18%良性间叶性肿瘤、5%炎症性病变和2%陈旧性血肿。只有45%的STS此前未接受过手术。其中,15%切除不完全,而39%的STS患者因局部复发入院。在这10年期间,STT和STS的转诊病例数相对稳定,但在观察期的最后2年,不完全切除或复发性STS患者的转诊病例数增加了一倍。
鉴于STT有众多鉴别诊断,STS的可能性以及软组织中的癌表现都应受到更多关注。为了减少STS再次手术和局部复发的相对较高数量,对可疑STT患者的治疗应留待专业中心进行。