Murtaza Hamza, Arain Abdul Rehman, Anoushiravani Afshin, Thadani Sean, de la Roza Gustavo, Naous Rana, Damron Timothy A
Albany Medical Center, Albany NY, USA.
St. Matthew's University, West Bay, Cayman Islands.
Case Rep Orthop. 2020 Feb 4;2020:3761015. doi: 10.1155/2020/3761015. eCollection 2020.
Osteosarcoma, the most common primary malignant bone tumor, rarely stains positive for epithelial markers such as cytokeratin on immunohistochemical analysis. We describe a 52-year-old man with a destructive distal femoral metaphyseal lesion who was initially treated for metastatic sarcomatoid carcinoma based on extensive radiographic and histopathologic evaluation. Ultimately, wide resection of the distal femur was performed, revealing high-grade conventional osteosarcoma with intense and diffuse cytokeratin positivity. Such immunohistochemical staining in osteosarcoma is rare, making it difficult to distinguish cytokeratin-positive osteosarcoma from metastatic carcinoma. The presence of a cytokeratin-positive bone neoplasm with malignant osteoid formation on histological studies as well as integration with clinical and radiologic data can help confirm osteosarcoma as the ultimate diagnosis.
骨肉瘤是最常见的原发性恶性骨肿瘤，在免疫组织化学分析中，很少上皮标志物（如细胞角蛋白）染色呈阳性。我们描述了一名52岁男性，其股骨远端干骺端有一个破坏性病变，最初基于广泛的影像学和组织病理学评估，被诊断为转移性肉瘤样癌并接受治疗。最终，对股骨远端进行了广泛切除，结果显示为高级别传统型骨肉瘤，细胞角蛋白呈强烈弥漫性阳性。骨肉瘤中这种免疫组织化学染色很罕见，使得难以将细胞角蛋白阳性的骨肉瘤与转移性癌区分开来。组织学研究中存在细胞角蛋白阳性且伴有恶性骨样形成的骨肿瘤，以及结合临床和放射学数据，有助于确诊骨肉瘤。
