Jassim S S, Hilton T, Saifuddin A, Pollock R
Bone Tumour Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
Eur J Orthop Surg Traumatol. 2020 Jan;30(1):97-102. doi: 10.1007/s00590-019-02532-1. Epub 2019 Aug 17.
The aim of this study is to describe outcomes of incidental chondral tumours in the shoulder referred to our Bone Tumour Unit (BTU).
Our hospital radiology database was searched using the filtered terms "enchondroma", "low-grade chondral tumour", "chondrosarcoma" with "humerus", "arm", "shoulder", "scapula" and "clavicle". Case note review of results assessed primary reasons for referral, radiological diagnosis, recommended management with subsequent reviews and outcomes, either in clinic or surveillance scan reports.
Ninety-nine patients had full case note review, mean age 54.5 years (range 18-84 years). Mean follow-up was 41.7 months (range 1-265 months). Over 50% of patients were referred for shoulder pain. Three patients had high-grade chondrosarcoma. Forty-three patients had interval scans, none showing any changes. Thirty-five patients had surgery for their lesions with one recurrence. Forty-four patients had alternative diagnoses made on clinical and radiological examination. At most recent follow-up, 70% of these patients were asymptomatic after physiotherapy/surgical attention to their alternative diagnoses.
Chondral lesions in the shoulder have low risk of malignant transformation and are rarely responsible for shoulder symptoms. We recommend patients be referred to a dedicated BTU for surveillance if there are any concerning features, but to proceed with management for any alternative diagnosis.
本研究旨在描述转诊至我们骨肿瘤科（BTU）的肩部偶然发现的软骨肿瘤的结果。
利用过滤词“内生软骨瘤”“低度软骨肿瘤”“软骨肉瘤”与“肱骨”“手臂”“肩部”“肩胛骨”和“锁骨”对我院放射学数据库进行检索。对检索结果进行病例记录回顾，评估转诊的主要原因、放射学诊断、推荐的治疗方案以及随后在临床或监测扫描报告中的复查和结果。
99例患者的病例记录得到全面回顾，平均年龄54.5岁（范围18 - 84岁）。平均随访时间为41.7个月（范围1 - 265个月）。超过50%的患者因肩部疼痛转诊。3例患者患有高级别软骨肉瘤。43例患者进行了定期扫描，均未显示任何变化。35例患者因病变接受了手术，1例复发。44例患者经临床和放射学检查有其他诊断。在最近一次随访中，这些患者中有70%在针对其其他诊断进行物理治疗/手术后无症状。
肩部软骨病变恶变风险低，很少是肩部症状的原因。我们建议，如果有任何令人担忧的特征，患者应转诊至专门的骨肿瘤科进行监测，但对于任何其他诊断应进行相应治疗。
