Evans S, Ramasamy A, Jeys L, Grimer R
Royal Orthopaedic Hospital, Birmingham, Birmingham, UK.
J Bone Oncol. 2014 Aug 14;3(3-4):77-9. doi: 10.1016/j.jbo.2014.08.001. eCollection 2014 Nov.
We identified thirteen patients with desmoplastic fibroma of bone treated at our institute over a 30 year period. The patients had a mean age of 25.9 years; eight were female. The incidence of desmoplastic fibroma of bone in all patients with benign bone tumours in our population is 0.003%. Surgical treatment ranged from primary amputation to intra-lesional curettage. The incidence of local recurrence was 15.4%. All cases of local recurrence after curettage or marginal excision demonstrated soft-tissue extension of their tumours on initial presentation suggesting that extra-osseous extension requires more radical surgery to control the disease. This study presents the largest single centre series of desmoplastic fibroma of bone with a mean follow-up time of 8 years. We recommend wide surgical excision, particularly if the lesion can be resected without significant loss of function, as the treatment modality of choice with the lowest rate of recurrence. Patients undergoing intra-lesional or marginal resection need to be advised of the possibility of local recurrence and the need for long-term surveillance.
我们确定了在我院30年间接受治疗的13例骨促结缔组织增生性纤维瘤患者。患者的平均年龄为25.9岁;8例为女性。在我们医院所有良性骨肿瘤患者中,骨促结缔组织增生性纤维瘤的发病率为0.003%。手术治疗范围从一期截肢到病灶内刮除术。局部复发率为15.4%。刮除术或边缘切除术后所有局部复发病例在初次就诊时均显示肿瘤有软组织扩展,这表明骨外扩展需要更彻底的手术来控制疾病。本研究呈现了最大的单中心骨促结缔组织增生性纤维瘤系列病例,平均随访时间为8年。我们建议广泛手术切除,特别是如果病变能够在不造成明显功能丧失的情况下切除,作为复发率最低的首选治疗方式。需要告知接受病灶内或边缘切除术的患者有局部复发的可能性以及长期监测的必要性。