Ehara S, Kattapuram S V, Egglin T K
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Cancer. 1991 Oct 1;68(7):1531-5. doi: 10.1002/1097-0142(19911001)68:7<1531::aid-cncr2820680712>3.0.co;2-t.
The radiographic appearance of Ewing's sarcoma was studied retrospectively in 22 patients who survived 5 years or longer after diagnosis and treatment. Expected changes from treatment, including regression of the extraosseous soft tissue mass, periostitis, and reconstitution of the cortex, occurred in all patients. Local recurrence occurred in one patient 10 years after complete remission whereas secondary osteosarcoma occurred more than 5 years after complete remission in two other cases. Both recurrent and secondary tumors presented as new lytic foci at the site of the original primary lesion. Lytic changes from radiation (radiation osteitis) may develop more than 2 years after treatment and in this sample; such findings were widely distributed in the radiation port. The authors conclude that bone remodeling and postradiation changes occur slowly over 2 years after treatment, and that any localized lysis at the primary site is suspicious for recurrence or secondary neoplasm. Knowledge of the expected changes and patterns of local recurrence and secondary neoplasms helps one to detect any significant change in its early phase.
对22例诊断和治疗后存活5年或更长时间的患者的尤因肉瘤的影像学表现进行了回顾性研究。所有患者均出现了治疗后的预期变化，包括骨外软组织肿块消退、骨膜炎和皮质重建。1例患者在完全缓解10年后出现局部复发，另外2例患者在完全缓解5年以上后发生继发性骨肉瘤。复发性肿瘤和继发性肿瘤均在原发病灶部位表现为新的溶骨性病灶。放疗引起的溶骨性改变（放射性骨炎）可能在治疗后2年以上出现，在本样本中，此类表现广泛分布于放疗区域。作者得出结论，骨重塑和放疗后改变在治疗后2年内缓慢发生，原发部位的任何局限性溶解都可疑为复发或继发性肿瘤。了解预期变化以及局部复发和继发性肿瘤的模式有助于在早期发现任何显著变化。
