Ibn Sellam A, Chaibainou A, Achir A, Allouch A, Bernoussi Z, Jahid A, Mahassini N, Achachi L, El Ftouh M, Benosman A, El Fassy Fihry M T
Service de pneumologie, Hôpital Ibn Sina, C.H.U de Rabat, Maroc.
Rev Mal Respir. 2006 Nov;23(5 Pt 1):453-7. doi: 10.1016/s0761-8425(06)71816-2.
Giant-cell tumors of bone are rare primary neoplasms commonly encountered in young adults. Women are slightly more affected than men.
We report the case a 27 year old woman presenting with a twelve months history of painful and progressively growing thoracic mass in the right anterior chest wall. Physical examination found out a fixed thoracic mass in the right retro-mammary area measuring 8 x 6 centimeters. The overlying skin was normal. Chest roentgenogram demonstrated a large ill defined mass continuing the anterior arc of the fourth right rib. Computed tomography evidenced a well defined pathologic process originating from the fourth right rib without expansion of the surrounding soft tissue. Pulmonary functional tests were normal and other complementary investigations evidenced no abnormalities. Our patient first had a fine needle cytological biopsy that brought strong suspicion of Giant-cell tumor of the rib. She then underwent an "en bloc" resection of the tumor whose histopathologic analysis allowed a definitive diagnosis. The post-surgical follow up during 12 months showed no signs of tumor recurrence.
Through this observation the authors emphasize not only the rarity of the giant-cell tumors of bone but also its unusual costal localization (few cases reported till date). They focus on the importance of precocious screening and treatment and underline the value of the follow up in order to detect timely any sign of local recurrence or sarcomatous transformation. Finally, they report a current review of the literature.
骨巨细胞瘤是一种罕见的原发性肿瘤,常见于年轻人。女性的发病率略高于男性。
我们报告一例27岁女性病例,该患者有12个月右前胸壁疼痛且逐渐增大的胸部肿块病史。体格检查发现右乳房后区域有一个固定的胸部肿块,大小为8×6厘米。覆盖其上的皮肤正常。胸部X线片显示一个边界不清的大肿块,延续至右第四肋的前弓。计算机断层扫描证实有一个边界清晰的病变起源于右第四肋,周围软组织无扩张。肺功能测试正常,其他辅助检查未发现异常。我们的患者首先进行了细针细胞学活检,强烈怀疑为肋骨巨细胞瘤。随后她接受了肿瘤的“整块”切除,其组织病理学分析得以确诊。术后12个月的随访未发现肿瘤复发迹象。
通过该病例,作者不仅强调了骨巨细胞瘤的罕见性,还强调了其不寻常的肋骨定位(迄今为止报道的病例很少)。他们强调了早期筛查和治疗的重要性,并强调了随访的价值,以便及时发现任何局部复发或肉瘤样变的迹象。最后,他们报告了当前的文献综述。