Meis J M, Enzinger F M
Department of Soft Tissue Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Hum Pathol. 1992 Jun;23(6):639-46. doi: 10.1016/0046-8177(92)90319-x.
We describe 65 cases of juxta-articular myxoma (JAM) that occurred in the vicinity of large joints, possessed histologic features of a myxoma, and were frequently associated with cystic changes that resembled a ganglion cyst. The vast majority of cases (57, 88%) occurred in the region of the knee; a minority involved the shoulder (three cases), elbow (three), ankle (one), and hip (one) regions. Patients' ages ranged from 16 to 83 years (median, 43 years; mean, 44 years) and nearly three fourths of the patients (72%) were male. Thirty-seven lesions presented as a swelling or mass, 21 were associated with pain or tenderness, and sizes ranged from 0.6 to 12 cm (median, 3.5 cm; mean, 3.8 cm). Duration of symptoms was highly variable, spanning from 1 week to 18 years. Fourteen JAMs were intimately associated with the meniscus and five of these had a concomitant tear; in five other cases JAM was an incidental finding at the time of total knee or hip arthroplasty for severe osteoarthritis. Of 29 cases with follow-up, 10 (34%) recurred: five recurred once, two recurred twice, two recurred three times, and one recurred four times. While the majority of JAMs were correctly diagnosed as benign, a sarcoma was seriously considered or diagnosed in 15 (23%) cases.
我们描述了65例关节周围黏液瘤(JAM),这些肿瘤发生在大关节附近,具有黏液瘤的组织学特征,且常伴有类似腱鞘囊肿的囊性改变。绝大多数病例(57例,88%)发生在膝关节区域;少数病例累及肩部(3例)、肘部(3例)、踝部(1例)和髋部(1例)区域。患者年龄范围为16至83岁(中位数为43岁;平均为44岁),近四分之三的患者(72%)为男性。37个病灶表现为肿胀或肿块,21个伴有疼痛或压痛,大小从0.6至12厘米不等(中位数为3.5厘米;平均为3.8厘米)。症状持续时间差异很大,从1周到18年不等。14例JAM与半月板密切相关,其中5例伴有半月板撕裂;在另外5例中,JAM是在严重骨关节炎患者行全膝关节或髋关节置换术时偶然发现的。在29例有随访的病例中,10例(34%)复发:5例复发1次,2例复发2次,2例复发3次,1例复发4次。虽然大多数JAM被正确诊断为良性,但在15例(23%)病例中曾严重怀疑或诊断为肉瘤。