Said M, Eldar S, Nash E, Mendes D
Dept. of General Surgery, Bnai-Zion Medical Center, Haifa.
Harefuah. 1990 Jun 15;118(12):684-7.
The peripelvic area consists of the bony pelvis, hip joints and adjacent mesenchymal soft tissues. Malignant lesions in this area present unique diagnostic and therapeutic problems, in particular when tumor removal is involved. Between 1986 and 1988 we treated 7 females and a male, aged 8-75 years, for malignant tumors of this area. Diagnoses (histologic) included 4 cases of malignant fibrous histiocytoma, a malignant schwannoma, a Ewing sarcoma, a chondrosarcoma, and an osteosarcoma. Operations included marginal resection (4 cases), radical resection and reconstruction (2), radical resection (1), and modified hemipelvectomy (2). Adjuvant therapy consisted of radiotherapy in 1 case, chemotherapy in 2, and a combination of both in another 2. A patient who underwent radical resection and reconstruction of his left hemipelvis and hip joint died of local infection that progressed to generalized sepsis 2 months after operation. 2 patients died of recurrent disease, 3 and 30 months, respectively, after primary therapy. 1 died of myocardial infarction 20 months after the first and 3 months after the last of a series of marginal resections. 3 patients are alive and well 3-24 months following their first operation, and the fourth is doing well 24 months following first operation and 23 months after resection of lung metastases. Soft tissue sarcomas and osteosarcomas are the most frequent malignant tumors encountered in the pelvis and peripelvic areas. Their varying grades of malignancy and metastatic potential influence the approach on the one hand, while invalidity and compromised quality of life associated with tumor resection, influence it on the other.(ABSTRACT TRUNCATED AT 250 WORDS)
盆腔周围区域由骨盆、髋关节及相邻的间充质软组织组成。该区域的恶性病变存在独特的诊断和治疗难题,尤其是涉及肿瘤切除时。1986年至1988年期间,我们治疗了7名女性和1名男性,年龄在8至75岁之间,他们患有该区域的恶性肿瘤。诊断(组织学)包括4例恶性纤维组织细胞瘤、1例恶性神经鞘瘤、1例尤因肉瘤、1例软骨肉瘤和1例骨肉瘤。手术包括边缘性切除(4例)、根治性切除及重建(2例)、根治性切除(1例)和改良半骨盆切除术(2例)。辅助治疗包括1例放疗、2例化疗以及另外2例放化疗联合。1例接受左半骨盆和髋关节根治性切除及重建的患者术后2个月死于局部感染并进展为全身脓毒症。2例患者分别在初次治疗后3个月和30个月死于疾病复发。1例在首次边缘性切除后20个月以及最后一次边缘性切除后3个月死于心肌梗死。3例患者在首次手术后3至24个月情况良好,第4例在首次手术后24个月以及肺转移瘤切除后23个月情况良好。软组织肉瘤和骨肉瘤是盆腔及盆腔周围区域最常见的恶性肿瘤。它们不同的恶性程度和转移潜能一方面影响治疗方法,另一方面,与肿瘤切除相关的功能丧失和生活质量下降也会产生影响。(摘要截选至250词)