De Santis E, Rosa M A, Gasparini G
Institute of Clinical Orthopaedics, University of Sassari.
Ital J Orthop Traumatol. 1987 Jun;13(2):207-17.
Eight cases are described of circumscribed heterotopic ossification in the soft tissues characterised by spontaneous onset, no history of trauma, and rapid course which have frequently led to a mistaken preoperative diagnosis of highly malignant tumour. The terminology differentiates it from myositis ossificans, which is a different entity. The authors emphasize the need for accurate evaluation of all the clinical and radiographic data in order to avoid an erroneous diagnosis of extraosseous osteogenic sarcoma or parosteal osteogenic sarcoma. In this regard, both radiography and histological examination demonstrate the so-called zoning pattern, namely a radiolucent central zone corresponding to the more immature area and consisting of fibrous tissue with active histiofibroblastic proliferations and a radiopaque peripheral area, where ossification is more mature the closer it gets to the periphery. Histological specimens obtained exclusively from the central area may lead even the most expert pathologists to a diagnosis of fibrosarcoma or osteogenic sarcoma. Finally, the pathogenetic aspects of the anomaly are discussed, as well as those concerned with the differential diagnosis from other types of heterotopic ossification.
本文描述了8例软组织局限性异位骨化病例，其特点为自发发病，无创伤史，病程进展迅速，术前常被误诊为高度恶性肿瘤。该术语将其与骨化性肌炎区分开来，后者是一种不同的疾病实体。作者强调，需要对所有临床和影像学数据进行准确评估，以避免误诊为骨外骨肉瘤或骨旁骨肉瘤。在这方面，X线摄影和组织学检查均显示出所谓的分区模式，即对应于较不成熟区域的透光中央区，由具有活跃组织细胞纤维母细胞增生的纤维组织组成，以及不透光的周边区，骨化越靠近周边越成熟。仅从中央区获取的组织学标本甚至可能导致最专业的病理学家诊断为纤维肉瘤或骨肉瘤。最后，讨论了该异常的发病机制，以及与其他类型异位骨化的鉴别诊断相关的问题。
