Atalar Hakan, Başarir Kerem, Uraş Ismail, Yildiz Yusuf, Erekul Selim, Sağlik Yener
Faith Universitesi Tip Fakültesi ve Hastanesi Ortopedi ve Travmatoloji Anabilim, Dali.
Acta Orthop Traumatol Turc. 2007;41(1):31-5.
We evaluated surgical treatment of patients with chondromyxoid fibroma.
The study included 11 patients (6 females, 5 males; mean age 31 years; range 8 to 53 years) who underwent surgical treatment for chondromyxoid fibroma. The most common site of involvement was the tibia in three patients. Diagnosis was made preoperatively by tru-cut biopsies in seven patients and all the diagnoses were confirmed postoperatively by histopathologic examination. In addition to plain radiographs, computed tomography was used in 10 patients, and magnetic resonance was used in six patients. Surgery included wide resection, marginal excision or intralesional curettage followed by autologous bone graft or bone cement. The mean follow-up was 62.8 months (range 2 to 162 months).
The main presenting symptom was pain in all the patients. Two patients with thoracic wall and tibia involvement, respectively, complained of a mass. Radiologic imaging showed soft tissue involvement in two patients. Recurrence occurred in three patients (27.3%), in whom initial surgical procedures were curettage alone (n=2) or with iliac graft (n=1). One patient with involvement in the phalanx of the thumb presented with pain 46 months after the second operation. A tru-cut biopsy yielded a diagnosis of secondary chondrosarcoma for which ray amputation was performed. No wound site infections or functional loss developed after surgical treatment.
Chondromyxoid fibroma may develop in various bones of the body and occur at a wide age range. Curettage with autologous bone graft is an effective surgical method.
我们评估了软骨黏液样纤维瘤患者的手术治疗情况。
该研究纳入了11例接受软骨黏液样纤维瘤手术治疗的患者(6例女性,5例男性;平均年龄31岁;范围8至53岁)。最常见的受累部位是3例患者的胫骨。7例患者术前通过切割活检确诊,所有诊断均经术后组织病理学检查证实。除了X线平片外,10例患者使用了计算机断层扫描,6例患者使用了磁共振成像。手术包括广泛切除、边缘切除或病损内刮除,随后进行自体骨移植或骨水泥填充。平均随访时间为62.8个月(范围2至162个月)。
所有患者的主要表现症状均为疼痛。2例分别累及胸壁和胫骨的患者主诉有肿块。放射学影像显示2例患者有软组织受累。3例患者(27.3%)出现复发,其中最初的手术操作仅为刮除(2例)或刮除加髂骨移植(例)。1例拇指指骨受累的患者在第二次手术后46个月出现疼痛。切割活检诊断为继发性软骨肉瘤,为此进行了射线截肢。手术治疗后未发生伤口部位感染或功能丧失。
软骨黏液样纤维瘤可发生于身体的各种骨骼,发病年龄范围广泛。刮除加自体骨移植是一种有效的手术方法。