Goedhart L M, Ploegmakers J J W, Kroon H M, Zwartkruis E C H, Jutte P C
University Medical Center, Groningen, The Netherlands.
University Medical Center Groningen, Groningen, The Netherlands.
Bone Joint J. 2014 Jun;96-B(6):823-8. doi: 10.1302/0301-620X.96B6.33037.
In this case study, we describe the clinical presentation and treatment of 36 patients with periosteal chondrosarcoma collected over a 59-year period by the archive of the Netherlands Committee on Bone Tumours. The demographics, clinical presentation, radiological features, treatment and follow-up are presented with the size, location, the histological grading of the tumour and the survival. We found a slight predominance of men (61%), and a predilection for the distal femur (33%) and proximal humerus (33%). The metaphysis was the most common site (47%) and the most common presentation was with pain (44%). Half the tumours were classified histologically as grade 1. Pulmonary metastases were reported in one patient after an intra-lesional resection. A second patient died from local recurrence and possible pulmonary and skin metastases after an incomplete resection. It is clearly important to make the diagnosis appropriately because an incomplete resection may result in local recurrence and metastatic spread. Staging for metastatic disease is recommended in grade II or III lesions. These patients should be managed with a contrast-enhanced MRI of the tumour and histological confirmation by biopsy, followed by en-bloc excision.
在本病例研究中,我们描述了荷兰骨肿瘤委员会档案库在59年期间收集的36例骨膜软骨肉瘤患者的临床表现及治疗情况。介绍了患者的人口统计学特征、临床表现、放射学特征、治疗及随访情况,包括肿瘤的大小、位置、组织学分级及生存情况。我们发现男性略占多数(61%),且好发于股骨远端(33%)和肱骨近端(33%)。干骺端是最常见的部位(47%),最常见的表现是疼痛(44%)。半数肿瘤组织学分类为1级。1例患者在病损内切除术后出现肺转移。另1例患者在不完全切除术后死于局部复发以及可能的肺和皮肤转移。正确诊断显然很重要,因为不完全切除可能导致局部复发和转移扩散。对于II级或III级病损,建议进行转移性疾病分期。这些患者应接受肿瘤的对比增强磁共振成像检查,并通过活检进行组织学确认,随后进行整块切除。