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食指远端指骨软骨肉瘤:临床报告与文献综述

Chondrosarcoma in the distal phalanx of index finger: clinical report and literature review.

作者信息

Tos P, Artiaco S, Linari A, Battiston B

机构信息

Department of Orthopaedics and Traumatology, UOD Reconstructive Microsurgery, ASO CTO-Maria Adelaide, Lungodora Firenze 87, Turin, Italy.

出版信息

Chir Main. 2009 Sep;28(4):265-9. doi: 10.1016/j.main.2009.02.002. Epub 2009 Mar 17.

Abstract

Chondrosarcoma is the most common primary malignant bone tumour of the hand. This aggressive lesion is extremely rare in the distal phalanx and requires differential diagnosis with enchondroma and onycomatrichoma which are specific neoplasms of this phalanx. We report a case of chondrosarcoma arising from left index distal phalanx, which developed over a long period of time with a progressive deformity of the distal phalanx before becoming painful. The patient was investigated with X-ray and MRI scan which demonstrated a locally aggressive lesion. The surgical procedure was discussed with the patient and consisted of a wide resection with distal phalanx amputation; this surgery left an acceptable functional impairment. Recently, the optimal treatment for chondrosarcoma of the finger has been debated in the literature and a more conservative surgical approach has been proposed. Local recurrence and metastasis have been reported in the literature. Thus, after surgical treatment, the patients should be followed with careful postoperative surveillance.

摘要

软骨肉瘤是手部最常见的原发性恶性骨肿瘤。这种侵袭性病变在远端指骨极为罕见,需要与内生软骨瘤和甲下骨疣进行鉴别诊断,这两种是该指骨的特异性肿瘤。我们报告一例起源于左手示指远端指骨的软骨肉瘤病例,该肿瘤在长时间内逐渐发展,远端指骨出现进行性畸形,之后才出现疼痛。对患者进行了X线和磁共振成像(MRI)扫描检查,结果显示为局部侵袭性病变。与患者讨论了手术方案,包括广泛切除并截肢远端指骨;该手术造成的功能损害在可接受范围内。最近,关于手指软骨肉瘤的最佳治疗方法在文献中存在争议,有人提出了更保守的手术方法。文献中报道了局部复发和转移的情况。因此,手术治疗后,应对患者进行仔细的术后监测随访。

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