Lee Kyung Hwa, Joo Jae Kyoon, Kim Dong Yi, Lee Ji Shin, Choi Chan, Lee Jae Hyuk
Department of Pathology, Chonnam National University Medical School, Hak-dong, Dong-gu, Gwangju, Republic of Korea.
BMC Cancer. 2007 May 15;7:82. doi: 10.1186/1471-2407-7-82.
Extraskeletal osteosarcoma is a rare malignant mesenchymal tumor, with a predominant occurrence in the extremities. Only two cases of mesenteric extraskeletal osteosarcoma have been documented. We describe an unusual case of extraskeletal osteosarcoma with telangiectatic features occurring in the mesentery.
A 67-year-old male presented with blood-tinged stool of 1-month's duration. On colonoscopy, a solid mass was detected protruding from the colon wall. Computed tomography showed a 15 x 9.7 cm heterogeneously enhancing mass, with mottled calcification and a cystic portion, occupying the left upper quadrant of the abdominal cavity. Curative resection of the tumor was performed, and the excised tumor was composed of large multilocular cysts containing old hematomas and necrotic debris. The histology revealed an osteosarcoma showing osteoid formation and blood-filled spaces lined with atypical cells. Despite postoperative chemotherapy, he developed a recurrent peritoneal mass and multiple lung metastases 3 months postoperatively.
Given the rarity of cases of mesenteric extraskeletal osteosarcoma, its biologic behavior at this location remains to be determined. However, extraskeletal osteosarcoma with telangiectatic features is an uncommon entity to be recognized because of the possible fatal outcome related to the tumors.
骨外骨肉瘤是一种罕见的恶性间叶性肿瘤,主要发生于四肢。仅有两例肠系膜骨外骨肉瘤的病例报道。我们描述了一例发生于肠系膜的具有毛细血管扩张特征的骨外骨肉瘤罕见病例。
一名67岁男性,出现持续1个月的便血症状。结肠镜检查发现一个从结肠壁突出的实性肿块。计算机断层扫描显示一个15×9.7厘米的不均匀强化肿块,伴有斑点状钙化和一个囊性部分,占据腹腔左上象限。对肿瘤进行了根治性切除,切除的肿瘤由含有陈旧性血肿和坏死碎片的大的多房囊肿组成。组织学检查显示为骨肉瘤,可见骨样形成以及充满血液的腔隙内衬非典型细胞。尽管术后进行了化疗,但他在术后3个月出现了复发性腹膜肿块和多发肺转移。
鉴于肠系膜骨外骨肉瘤病例罕见,其在此部位的生物学行为仍有待确定。然而,具有毛细血管扩张特征的骨外骨肉瘤是一种罕见的实体瘤,因其可能导致致命后果而需要被认识。