骨母细胞瘤会恶变为恶性肿瘤吗？良性脊柱肿瘤决策过程中的挑战。
Can Osteoblastoma Evolve to Malignancy? A Challenge in the Decision-Making Process of a Benign Spine Tumor.
机构信息
Department of Orthopaedic Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA; Department of Neurosurgery, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
出版信息
World Neurosurg. 2020 Apr;136:150-156. doi: 10.1016/j.wneu.2019.11.148. Epub 2019 Dec 4.
BACKGROUND
Osteoblastoma is a rare benign aggressive tumor, with one third occurring in the spine. Conversion of osteoblastoma to osteosarcoma is uncommon, and histologically proven conversion has been rarely reported.
CASE DESCRIPTION
Cases of 2 patients with rare occurrences of spinal osteoblastomas recurring and transforming into osteosarcomas are presented. Initial presentation, treatment, imaging, and histology findings are described. The outcomes of the patients following surgical intervention for histologically diagnosed osteoblastoma with subsequent transformation to osteosarcoma and relative management are described. A literature review of osteoblastoma converting to osteosarcoma also is provided.
CONCLUSIONS
The rare occurrence of osteoblastoma converting to osteosarcoma imparts several lessons, including performing Enneking appropriate surgery for benign aggressive tumors (Enneking stage 3) and always performing a biopsy, particularly at the time of recurrence if imaging is not pathognomonic for a benign primary spine tumor.
背景
成骨细胞瘤是一种罕见的良性侵袭性肿瘤，三分之一发生在脊柱。成骨细胞瘤向骨肉瘤的转化并不常见，且经组织学证实的转化很少见。
病例描述
我们报告了 2 例罕见的脊柱成骨细胞瘤复发并转化为骨肉瘤的病例。描述了初始表现、治疗、影像学和组织学发现。对经组织学诊断为成骨细胞瘤且随后转化为骨肉瘤的患者进行手术干预后的结果以及相关治疗进行了描述。还对成骨细胞瘤转化为骨肉瘤的文献进行了回顾。
结论
成骨细胞瘤向骨肉瘤的罕见转化带来了一些教训，包括对良性侵袭性肿瘤（恩氏 3 期）进行适当的恩氏手术，以及始终进行活检，特别是在影像学对良性原发性脊柱肿瘤无特征性表现时，如果出现复发。
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