继发于脊柱活动部巨细胞瘤的动脉瘤样骨囊肿:11 例报告。
Aneurysmal bone cyst secondary to giant cell tumor of the mobile spine: a report of 11 cases.
机构信息
Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
出版信息
Spine (Phila Pa 1976). 2011 Oct 1;36(21):E1385-90. doi: 10.1097/BRS.0b013e31820e60b2.
STUDY DESIGN
A retrospective analysis was performed.
OBJECTIVE
To analyze the characteristics of aneurysmal bone cyst arising from giant cell tumor of the mobile spine and to discuss the outcome of corresponding surgical and nonsurgical treatment.
SUMMARY OF BACKGROUND DATA
Giant cell tumors are generally benign neoplasms that exhibit aggressive behavior with a tendency to recur locally. Aneurysmal bone cysts are benign, highly vascular osseous lesions. Although both of them have been described separately in previous literatures, few reports have described aneurysmal bone cyst secondary to giant cell tumor of the mobile spine.
METHODS
Between January 2004 and December 2009, 11 patients were identified with an aneurysmal bone cyst arising from giant cell tumor of the mobile spine. Four patients underwent subtotal tumor resection followed by radiotherapy, and the other 7 patients underwent total tumor resection. Patients with lesions located below T6 were treated with selective arterial embolization before surgery. Clinical data and the efficacy of surgery were analyzed via chart review
RESULTS
Of the eleven patients identified for inclusion in this study, the average age was 33 months (range ∇ 14-65 months). The mean length of follow-up was 31 months. Seven patients kept disease-free during the follow-ups. The remaining four patients recurred and one died of local re-recurrence and lung metastasis.
CONCLUSION
Unlike primary aneurysmal bone cyst, secondary aneurysmal bone cyst arising from giant cell tumor of the mobile spine has a more aggressive tendency to recurrence locally. Complete resection with systematic radiotherapy should be undertaken for the treatment of aneurysmal bone cyst secondary to giant cell tumor of the mobile spine, which is associated with a good prognosis for local tumor control. As complete or as radical an operation as possible should be performed at first presentation. The best chance for the patient is the first chance. Selective preoperative embolization is advised to minimize intraoperative blood loss.
研究设计
回顾性分析。
目的
分析脊柱活动区巨细胞瘤继发动脉瘤样骨囊肿的特点,并探讨相应手术和非手术治疗的结果。
背景资料总结
巨细胞瘤一般为良性肿瘤,具有局部复发的侵袭性生长倾向。动脉瘤样骨囊肿是一种良性、高度血管化的骨病变。尽管它们在以前的文献中都有单独描述,但很少有报道描述脊柱活动区巨细胞瘤继发动脉瘤样骨囊肿。
方法
2004 年 1 月至 2009 年 12 月,共发现 11 例脊柱活动区巨细胞瘤继发动脉瘤样骨囊肿患者。4 例患者行次全肿瘤切除术加放疗,7 例患者行全肿瘤切除术。T6 以下病变患者术前选择性动脉栓塞。通过病历回顾分析临床资料和手术疗效。
结果
本研究共纳入 11 例患者,平均年龄为 33 个月(范围 14-65 个月)。平均随访时间为 31 个月。7 例患者随访期间无疾病。其余 4 例复发,1 例因局部复发和肺转移死亡。
结论
与原发性动脉瘤样骨囊肿不同,脊柱活动区巨细胞瘤继发动脉瘤样骨囊肿局部复发的侵袭性倾向更强。对于脊柱活动区巨细胞瘤继发动脉瘤样骨囊肿,应行完整切除加系统放疗,局部肿瘤控制效果良好。对于脊柱活动区巨细胞瘤继发动脉瘤样骨囊肿,应在首次就诊时尽可能行完整或根治性手术。第一次机会是最好的机会。建议选择性术前栓塞以减少术中失血。