Hoshi Manabu, Matsumoto Seiichi, Manabe Jun, Tanizawa Taisuke, Shigemitsu Toshio, Takeuchi Kengo, Kawaguchi Noriyoshi
Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan.
Jpn J Clin Oncol. 2006 Mar;36(3):180-4. doi: 10.1093/jjco/hyi243. Epub 2006 Mar 13.
High-grade surface osteosarcoma is the rarest of the three types of surface osteosarcoma. Four cases with high-grade surface osteosarcoma arising from the distal femur and tibia are reported in this study. One patient was previously diagnosed with Turner's syndrome. Radiologically, three cases presented characteristic appearances suggesting high-grade bone-forming sarcoma arising from the bone surface; however, one case was similar to other juxtacortical lesions such as periosteal and parosteal osteosarcoma, which typically have a better prognosis than high-grade surface osteosarcoma. Therefore, all cases underwent biopsy to determine a definitive diagnosis. Our strategy of treatment for high-grade surface osteosarcoma was a combination of wide resection and pre-/post-operative chemotherapy, equivalent to the treatment for conventional intramedullary osteosarcoma. At the last follow-up, two cases were still undergoing chemotherapy, one case was continuously disease free during the follow-up period of 81 months, and one patient was living with no evidence of disease 60 months after surgery. The aim of this study is to report the clinical information, oncological outcome and appropriate treatment for high-grade surface osteosarcoma.
高级别表面骨肉瘤是三种表面骨肉瘤中最为罕见的类型。本研究报告了4例发生于股骨远端和胫骨的高级别表面骨肉瘤病例。其中1例患者曾被诊断为特纳综合征。在影像学上，3例呈现出提示骨表面发生高级别成骨性肉瘤的特征性表现；然而，1例与其他皮质旁病变（如骨膜骨肉瘤和骨旁骨肉瘤）相似，这些病变的预后通常比高级别表面骨肉瘤要好。因此，所有病例均接受了活检以明确诊断。我们针对高级别表面骨肉瘤的治疗策略是广泛切除与术前/术后化疗相结合，这与传统髓内骨肉瘤的治疗方法相同。在最后一次随访时，2例仍在接受化疗，1例在81个月的随访期内持续无病生存，1例患者术后第60个月时无疾病迹象。本研究的目的是报告高级别表面骨肉瘤的临床信息、肿瘤学结局及合适的治疗方法。
