Vasić Ljiljana
Department of Radiotherapy, Clinical Centre Kragujevac.
Med Pregl. 2010 Sep-Oct;63(9-10):719-22. doi: 10.2298/mpns1010719v.
Despite the availability of an efficient screening protocol review, colon cancer is a leading health problem of the world population. At the time of diagnosis about 25% of cases have distant metastases. Distant metastases are most frequently metastases in the liver, lungs, brain, but they are rare in the bones. An early diagnosis of secondary deposits in the bones of the hand can be very difficult. The symptoms are subclinical or similar to other bone diseases. They appear in the advanced disease, and treatment is palliative. The treatment (radiotherapy, chemotherapy, surgery) is determined according to the general condition of the patient and the localization of the lesion. Radiotherapy can reduce tumor mass and reduce pain especially among patients with multiple lesions or inoperable ones. The aim of this paper was to: (1) present a case of secondary deposits of adenocarcinoma of the colon in the hand bones, (2) present the incidence, (3) give differential diagnoses and (4) describe the air treatment by unconventional regime of fractionation. The approach to the treatment of metastatic hands must be multi-disciplinary including an orthopedist, radiologist, oncologist and pathologist. It is important to know the importance of early recognition of these lesions.
尽管有高效的筛查方案评估，但结肠癌仍是全球人口面临的主要健康问题。在诊断时，约25%的病例已有远处转移。远处转移最常见于肝脏、肺、脑，但在骨骼中则较为罕见。手部骨骼继发性沉积物的早期诊断可能非常困难。症状为亚临床症状或与其他骨病相似。它们出现在疾病晚期，治疗为姑息性治疗。治疗（放疗、化疗、手术）根据患者的一般状况和病变部位来确定。放疗可缩小肿瘤体积并减轻疼痛，尤其是在有多处病变或无法手术的患者中。本文的目的是：（1）介绍一例结肠癌手部骨骼继发性沉积物病例，（2）介绍发病率，（3）进行鉴别诊断，（4）描述采用非常规分割方案的治疗方法。手部转移瘤的治疗方法必须是多学科的，包括骨科医生、放射科医生、肿瘤内科医生和病理科医生。了解早期识别这些病变的重要性很重要。
