Egea-Gámez R M, Ponz-Lueza V, Cendrero-Torrado A, Martínez-González C, Certucha-Barragán J A, González-Díaz R
Unidad de Raquis, Servicio de Traumatología y Ortopedia Infantil, Hospital Infantil Universitario Niño Jesús, Madrid, España.
Servicio de Ortopedia y Traumatología, Hospital Universitario Clínico San Carlos, Madrid, España.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2019 Mar-Apr;63(2):122-131. doi: 10.1016/j.recot.2018.09.001. Epub 2019 Feb 8.
Osteosarcoma is the most frequent malignant spinal tumour in the paediatric age group. Diagnosis and early treatment of this pathology is essential for a good prognosis. The aim of this study was to present the results of treatment of paediatric patients with lumbar osteosarcoma and conduct a literature review.
All the patients with lumbar osteosarcoma who were operated between 2012 and 2014 in the same centre were included. Demographic and radiological data (Enneking, WBB and Tomita classification), as well as anatomopathological (Broders classification) variables were analysed. All the patients were treated by surgical resection associated with adjuvant therapies (chemotherapy and radiotherapy); according to consensus with the tumour committee. The average follow-up was 62.53 months (47-70 months).
A total of 3 patients were studied, two girls of 9 and 11, with L5 osteosarcoma, and a 15-year-old boy with L4 osteosarcoma. Two of the cases were initially treated as an osteoblastoma, supported by radiological and anatomopathological images. None of the patients had local recurrences or metastases during follow-up.
Due to a lack of long series of cases of osteosarcoma in the mobile spine during childhood, the optimal treatment and prognosis in these patients is uncertain. Block resection improves local control of the disease, without demonstrating improvement in overall survival. Intralesional resection is associated with a higher rate of local recurrence. Oncological treatment is essential in the treatment of this pathology. A correct differential diagnosis of the tumour (osteosarcoma vs. osteoblastoma) is vital for its correct treatment.
骨肉瘤是儿童年龄组中最常见的脊柱恶性肿瘤。对这种疾病进行诊断和早期治疗对于良好的预后至关重要。本研究的目的是介绍小儿腰椎骨肉瘤患者的治疗结果并进行文献综述。
纳入2012年至2014年在同一中心接受手术的所有腰椎骨肉瘤患者。分析人口统计学和放射学数据（Enneking、WBB和Tomita分类）以及解剖病理学（Broders分类）变量。所有患者均接受与辅助治疗（化疗和放疗）相关的手术切除；根据与肿瘤委员会的共识进行。平均随访时间为62.53个月（47 - 70个月）。
共研究了3例患者，两名分别为9岁和11岁的女孩，患有L5骨肉瘤，以及一名15岁男孩患有L4骨肉瘤。其中两例最初被诊断为骨母细胞瘤，有放射学和解剖病理学图像支持。随访期间所有患者均无局部复发或转移。
由于儿童期活动脊柱骨肉瘤的病例系列较少，这些患者的最佳治疗方法和预后尚不确定。整块切除可改善疾病的局部控制，但未显示总体生存率有所提高。病灶内切除与较高的局部复发率相关。肿瘤治疗对于这种疾病的治疗至关重要。对肿瘤（骨肉瘤与骨母细胞瘤）进行正确的鉴别诊断对其正确治疗至关重要。
