Shiota Hironobu, Yasukawa Tomohisa, Hirai Ayako, Chiyo Masako, Yusa Toshikazu, Hiroshima Kenzo
Department of General Thoracic Surgery, Chiba Rosai Hospital, Ichihara, Chiba, Japan.
Ann Thorac Cardiovasc Surg. 2013;19(4):297-301. doi: 10.5761/atcs.cr.12.01964. Epub 2012 Nov 17.
Extraskeletal osteosarcoma is a rare malignant tumor occurring very rarely in the pleura. We herein report the case of 67-year-old man with asbestos exposure, who underwent biopsies of the large tumor from the chest wall, and diagnosed as a suspicious of fibrosarcoma. Surgical resection was done, and the pathological diagnosis was extraskeletal osteosarcoma arising from the pleura. The differential diagnosis is malignant pleural mesothelioma with osseous and cartilaginous which is also very rare and one of the histopathological subtypes with heterologous elements. Identification of epithelial components, labeling for cytokeratins in spindle cells and its' anatomical distribution may help to distinguish them. In the neoplasm arising from the parietal pleura, primary extraskeletal osteosarcoma of the pleura is very rare, but should be considered.
骨外骨肉瘤是一种罕见的恶性肿瘤，极少发生于胸膜。我们在此报告一例67岁有石棉接触史的男性患者，其胸壁的巨大肿瘤接受了活检，最初诊断为疑似纤维肉瘤。随后进行了手术切除，病理诊断为起源于胸膜的骨外骨肉瘤。鉴别诊断包括同样非常罕见的伴有骨和软骨成分的恶性胸膜间皮瘤，它是具有异源性成分的组织病理学亚型之一。识别上皮成分、标记梭形细胞中的细胞角蛋白及其解剖分布可能有助于区分它们。在起源于壁层胸膜的肿瘤中，原发性胸膜骨外骨肉瘤非常罕见，但应予以考虑。
