von Eisenhart-Rothe R, Toepfer A, Salzmann M, Schauwecker J, Gollwitzer H, Rechl H
Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
Orthopade. 2011 Dec;40(12):1121-42. doi: 10.1007/s00132-011-1866-7.
Among human neoplasms, primary malignant bone tumors are fairly rare. They present an incidence rate of roughly 10 cases per 1 million inhabitants per year. During childhood (<15 years), the percentage of malignant bone tumors amounts to 6% of all infantile malignancies. Only leukemia and lymphoma show a higher incidence in adolescence. Of all primary malignant bone tumors, 60% affect patients younger than 45 years and the peak incidence of all bone tumors occurs between 15 and 19 years. The most common primary malignant bone tumors are osteosarcoma (35%), chondrosarcoma (25%), and Ewing's sarcoma (16%). Less frequently (≤ 5%) occurring tumors are chordoma, malignant fibrous histiocytoma of bone, and fibrosarcoma of bone. Vascular primary malignant tumors of bone and adamantinoma are very rare. Staging of the lesion is essential for systemic therapeutic decision-making and includes complete imaging and histo-pathological confirmation of the suspected entity. In most cases, this is established by open- or image-guided biopsy. Based on this information, an interdisciplinary tumor board will determine the individual therapeutic approach. Endoprosthetic or biological reconstruction following wide tumor resection is the most common surgical therapy for primary malignant bone tumors. There is vital importance in a thorough postoperative follow-up and continous after-care by a competent tumor center which is permanentely in charge of therapy.
在人类肿瘤中，原发性恶性骨肿瘤相当罕见。其发病率约为每年每100万居民中有10例。在儿童期（<15岁），恶性骨肿瘤占所有儿童恶性肿瘤的6%。只有白血病和淋巴瘤在青少年中的发病率更高。在所有原发性恶性骨肿瘤中，60%的患者年龄小于45岁，所有骨肿瘤的发病高峰出现在15至19岁之间。最常见的原发性恶性骨肿瘤是骨肉瘤（35%）、软骨肉瘤（25%）和尤因肉瘤（16%）。较少见（≤5%）的肿瘤是脊索瘤、骨恶性纤维组织细胞瘤和骨纤维肉瘤。骨血管原发性恶性肿瘤和造釉细胞瘤非常罕见。病变分期对于系统性治疗决策至关重要，包括对可疑病变进行完整的影像学检查和组织病理学确诊。在大多数情况下，这通过开放活检或影像引导活检来确定。基于这些信息，多学科肿瘤委员会将确定个体化的治疗方法。广泛肿瘤切除术后的人工关节置换或生物重建是原发性恶性骨肿瘤最常见的手术治疗方法。由负责治疗的专业肿瘤中心进行全面的术后随访和持续的后续护理至关重要。
