Panotopoulos J, Funovics P Th, Windhager R
Universitätsklinik für Orthopädie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
Orthopade. 2017 Jun;46(6):473-476. doi: 10.1007/s00132-017-3426-2.
Benign bone tumors are heterogeneous and have different biological behaviors. Treatment requires knowledge of the principle diagnosis and clinical behavior to avoid, on the one hand, overtreatment and, on the other hand, incorrect diagnosis of a potentially malignant tumor.
Bone tumors of stage I (according to Enneking) should be observed clinically and radiologically. For stage II and stage III lesions, a biopsy should be performed, based on the corresponding oncological guidelines.
Soft tissue tumors have a different radiological behavior (especially in magnetic resonance images): while a lack of sharp cortical margins in bone tumors indicates an aggressive behavior, sharp margins in soft tissue tumors should not be misinterpreted as benign tumors. Subfascial soft tissue tumors, tumors larger than 2 cm, growing tumors, and persisting tumors after trauma require biopsy.
良性骨肿瘤具有异质性，且生物学行为各异。治疗需要掌握主要诊断原则和临床行为，一方面避免过度治疗，另一方面避免对潜在恶性肿瘤的误诊。
I期（根据恩内金分期）骨肿瘤应进行临床和影像学观察。对于II期和III期病变，应根据相应的肿瘤学指南进行活检。
软组织肿瘤具有不同的放射学表现（尤其是在磁共振成像中）：骨肿瘤中皮质边缘不清晰提示侵袭性生长，而软组织肿瘤边缘清晰不应被误诊为良性肿瘤。筋膜下软组织肿瘤、直径大于2厘米的肿瘤、生长中的肿瘤以及创伤后持续存在的肿瘤需要进行活检。
