Sharma H, Jane M J, Reid R
Scottish Bone Tumour and Sarcoma Service, Western Infirmary, Glasgow, G11 6NT, UK.
Int Orthop. 2006 Jun;30(3):205-9. doi: 10.1007/s00264-005-0046-y. Epub 2006 Mar 18.
Ten cases of histologically proven chondromyxoid fibroma (CMF) of the foot and ankle with a mean follow-up of 6.1 years were retrospectively reviewed using the Scottish Bone Tumour Registry. The patients' mean age was 19 years; there were six males and four females. The anatomical locations were five phalangeal, three metatarsal, one tarsal affecting body of os calcis and one distal tibial. The median delay in presentation was 4.5 months. The modes of presentation were pain only (n=4), painful lump (n=4) and painless lump (n=2). The typical radiological finding was an expansile, lobulated, cystic lesion. Cortical erosion was documented in 80% patients. In four cases, curettage alone was carried out, while five patients underwent curettage along with autogenous bone grafting. One patient with distal phalangeal CMF had a primary toe amputation. Two patients had recurrences 9 and 16 months after their initial curettage. Both of them were males with proximal phalangeal CMF, associated with cortical erosion. Foot and phalangeal CMF initially treated with curettage only should be closely followed up, as we observed a 20% recurrence rate within a 2-year period. Cases featuring cortical erosion require thorough curettage and may require autogenous bone grafting to prevent fracture.
利用苏格兰骨肿瘤登记处,对10例经组织学证实的足踝部软骨黏液样纤维瘤(CMF)病例进行回顾性分析,平均随访6.1年。患者平均年龄19岁,男性6例,女性4例。病变部位包括5例趾骨、3例跖骨、1例累及跟骨体的跗骨和1例胫骨远端。就诊延迟的中位数为4.5个月。临床表现为仅疼痛(4例)、疼痛性肿块(4例)和无痛性肿块(2例)。典型的影像学表现为膨胀性、分叶状囊性病变。80%的患者有皮质骨侵蚀记录。4例仅行刮除术,5例患者在刮除术的同时进行了自体骨移植。1例远端趾骨CMF患者接受了一期趾截肢术。2例患者在初次刮除术后9个月和16个月复发。他们均为近端趾骨CMF男性患者,伴有皮质骨侵蚀。仅行刮除术初始治疗的足趾和趾骨CMF应密切随访,因为我们观察到2年内复发率为20%。有皮质骨侵蚀的病例需要彻底刮除,可能需要自体骨移植以防止骨折。