Mazabraud A, Florent J, Laurent M
Institut Curie, Paris, France.
Bull Cancer. 1989;76(6):573-81.
Several cases of sarcomas which developed in contact with joint prosthetic material were reported previously. They were mostly malignant fibrous histiocytoma, but to our knowledge, no case of epidermoid carcinoma was reported. We report here one case of epidermoid carcinoma which developed in contact with a hip prosthesis. Surgery was complicated by local infection and necessitated multiple reoperations, which may be responsible for the implantation of skin cells. It is generally admitted that multiple factors contribute to the development of a tumor clone. In our patient we must take into consideration such factors as chronic infection with fistula and prosthetic material. However carcinomas, even rare, which form on fistulas appear only after many years of suppuration. The short delay between the prosthesis setting and the carcinoma onset in our patients, suggests that a cofactor may have speeded up tumor induction. This cofactor could be the platelet derived growth factor (PDGF) in the case of sarcomas appearing on bone infarcts without foreign body introduction, and possibly other tumors.
此前曾有几例与关节假体材料接触后发生肉瘤的病例报道。这些病例大多为恶性纤维组织细胞瘤,但据我们所知,尚无表皮样癌的病例报道。我们在此报告1例与髋关节假体接触后发生的表皮样癌。手术因局部感染而复杂化,需要多次再次手术,这可能导致皮肤细胞植入。一般认为多种因素促成肿瘤克隆的发生。对于我们的患者,必须考虑诸如伴有瘘管的慢性感染和假体材料等因素。然而,即使罕见,在瘘管上形成的癌也仅在多年化脓后才出现。我们患者中假体植入与癌发病之间的间隔时间较短,提示可能有一个辅助因子加速了肿瘤诱导。在无异物植入的骨梗死部位出现的肉瘤以及可能的其他肿瘤病例中,这个辅助因子可能是血小板衍生生长因子(PDGF)。