Sharma Himanshu, MacDuff E, Jane M J, Reid R
University Department of Orthopaedic Surgery/Scottish Bone Tumour Registry, Western Infirmary, Glasgow, G11 6NT, UK.
Int Orthop. 2005 Oct;29(5):319-25. doi: 10.1007/s00264-005-0673-3. Epub 2005 Aug 11.
We reviewed 13 cases of tibial Paget's sarcoma constituting 14% of all registered Paget's sarcoma cases of the Scottish Bone Tumour Registry between January 1947 and June 2004. Eleven patients were male, and in ten patients the tumour involved the upper half of the tibia. In all cases, the main presenting feature was progressively worsening pain followed by a mass in six, a pathological fracture in five and tibial bowing in four. In nine patients, a lytic lesion was seen radiologically. Histologically, there were three osteosarcomas and ten malignant fibrous histiocytomas. Limb ablation was carried out in 11 patients, of whom nine had trans-femoral amputation. Six patients received adjuvant radiotherapy and/or chemotherapy. Post-operative complications included stump revision in two cases, non-union of a pathological fracture of the tibial tuberosity and a stress fracture. The median survival was 17 months.
我们回顾了13例胫骨佩吉特肉瘤病例，这些病例占1947年1月至2004年6月间苏格兰骨肿瘤登记处所有登记的佩吉特肉瘤病例的14%。11例为男性，10例患者的肿瘤累及胫骨上半部分。所有病例的主要表现特征均为疼痛逐渐加重，随后6例出现肿块，5例发生病理性骨折，4例出现胫骨弯曲。9例患者影像学检查可见溶骨性病变。组织学检查显示，有3例骨肉瘤和10例恶性纤维组织细胞瘤。11例患者进行了肢体切除，其中9例行经股骨截肢术。6例患者接受了辅助放疗和/或化疗。术后并发症包括2例残端修复、胫骨结节病理性骨折不愈合和1例应力性骨折。中位生存期为17个月。
