Crouzet J, Beraneck L, Bellony R, Bouteiller G, Bontoux D, Camus J P, Liote' F, Prost A, Taillandier J, Wendling L
Service de Rhumatologie, Centre Hospitalier de Corbeil-Essonnes.
Rev Rhum Mal Osteoartic. 1990 Jul-Sep;57(7-8):517-20.
The authors collected observations concerning 11 newly histologically proved cases of a combination of Paget's disease and carcinoma metastatic to bone on the same bone from members of the French Rheumatology Society. The most frequent locations can be specified from their analysis and an analysis of 26 detailed cases from the literature, i.e. pelvis, femur, rachis, tibia, humerus, and the cancers most frequently involved--prostate, bronchi, kidney, breast and intestine. The most usual histological appearance is osteolytic, except in the case of prostatic carcinoma. The metastasis reveals the presence of cancer in 2 cases out of 3, whereas Paget's disease is most often already diagnosed. A histological examination is necessary because of the risk of non recognition of such metastases or of confusion with sarcomatous degeneration. It does not appear to be exceptional to find Paget's disease in combination with a metastasis on the same bone. Although six of the cases concern metastases only located at sites of Paget's disease, an analysis of all the cases does not seem to indicate that Paget bone is more exposed to metastases than normal bone, since both diseases in fact locate preferentially at the same sites on the skeleton.
作者收集了法国风湿病学会成员提供的11例新的经组织学证实的佩吉特病与骨转移癌合并发生在同一骨头上的病例观察资料。通过对这些病例以及文献中26例详细病例的分析，可以明确最常见的发病部位，即骨盆、股骨、脊柱、胫骨、肱骨，以及最常受累的癌症——前列腺癌、支气管癌、肾癌、乳腺癌和肠癌。除前列腺癌外，最常见的组织学表现为溶骨性。在三分之二的病例中，转移灶提示癌症的存在，而佩吉特病通常已被诊断出来。由于存在无法识别此类转移灶或与肉瘤样变性混淆的风险，因此有必要进行组织学检查。在同一骨头上发现佩吉特病合并转移似乎并不罕见。虽然其中6例仅涉及位于佩吉特病部位的转移灶，但对所有病例的分析似乎并未表明佩吉特骨比正常骨更容易发生转移，因为事实上这两种疾病都优先发生在骨骼的相同部位。
