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足部骨骼的原发性肿瘤和肿瘤样病变:166例单中心经验

Primary Tumor and Tumor-Like Lesions of Bones of the Foot: Single-Center Experience of 166 Cases.

作者信息

Özer Devrim, Aycan Osman Emre, Er Sait Turgay, Tanrıtanır Rahime, Arıkan Yavuz, Kabukçuoğlu Yavuz Selim

机构信息

Orthopaedic Surgeon, Orthopaedic Oncology Clinic, Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey.

Orthopaedic Surgeon, Siverek State Hospital, Siverek, Sanliurfa, Turkey.

出版信息

J Foot Ankle Surg. 2017 Nov-Dec;56(6):1180-1187. doi: 10.1053/j.jfas.2017.05.027.

Abstract

Primary bone tumors of the foot are rare lesions. The purpose of the present study was to evaluate the clinical manifestations, treatment modalities, and recurrences of various primary bone tumors of the foot from a specialized center for orthopedic oncology. Among 3681 musculoskeletal tumor cases, which were diagnosed and surgically treated in our hospital from 1983 to 2013, 166 primary tumor and tumor-like bone lesions of the foot (4.5%) were retrospectively reviewed regarding age, gender, localization, biopsy-revealed diagnosis, applied treatment modalities, follow-up period, and recurrence, if any. Of the 166 primary bone tumors of the foot, 155 (93.4%) were benign and 11 (6.6%) were malignant. The most common primary benign bone tumor was a unicameral bone cyst (57 of 155; 36.8%), and the most common malignant tumor was chondrosarcoma (7 of 11; 63.6%). The hindfoot was the most common location for both primary benign (104 of 155; 67.1%) and malignant (6 of 11; 54.5%) bone tumors of the foot. The results of our study have confirmed that the radiologic findings can be confusing owing to the structural and histopathologic features of the bones of the foot; thus, histopathologic diagnosis should be considered for foot involvement. Because the characteristics of the compartments in the foot allow for the rapid spread of malignant lesions, aggressive surgical management and wider resection are recommended to prevent recurrence and further spread.

摘要

足部原发性骨肿瘤是罕见病变。本研究的目的是从一家骨科肿瘤专科医院评估各种足部原发性骨肿瘤的临床表现、治疗方式及复发情况。在1983年至2013年于我院诊断并接受手术治疗的3681例肌肉骨骼肿瘤病例中,对166例足部原发性肿瘤及肿瘤样骨病变(4.5%)进行了回顾性研究,内容包括年龄、性别、病变部位、活检确诊的诊断、应用的治疗方式、随访期以及是否复发。在这166例足部原发性骨肿瘤中,155例(93.4%)为良性,11例(6.6%)为恶性。最常见的原发性良性骨肿瘤是单房骨囊肿(155例中的57例;36.8%),最常见的恶性肿瘤是软骨肉瘤(11例中的7例;63.6%)。后足是足部原发性良性(155例中的104例;67.1%)和恶性(11例中的6例;54.5%)骨肿瘤最常见的发病部位。我们的研究结果证实由于足部骨骼的结构和组织病理学特征,影像学表现可能具有迷惑性;因此,足部受累时应考虑进行组织病理学诊断。由于足部各间隙的特点使得恶性病变易于快速扩散,建议采取积极的手术治疗并进行更广泛的切除以防止复发和进一步扩散。

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