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奥里耶病和马富西综合征的自然病史:患者调查和临床文献复习。

Natural history of Ollier disease and Maffucci syndrome: Patient survey and review of clinical literature.

机构信息

Department of Orthopedic Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

出版信息

Am J Med Genet A. 2020 May;182(5):1093-1103. doi: 10.1002/ajmg.a.61530. Epub 2020 Mar 7.

Abstract

Ollier disease (OD) and Maffucci syndrome (MS) are characterized by multiple enchondromas. Patients with MS also have benign vascular overgrowths that become malignant in 8.5% of cases. OD is characterized by multiple enchondromas, typically unilateral in distribution with a predilection for the appendicular skeleton. MS is characterized by multiple enchondromas bilaterally distributed in most of the cases. Both disorders feature multiple swellings on the extremity, deformity around the joints, limitations in joint mobility, scoliosis, bone shortening, leg-length discrepancy, gait disturbances, pain, loss of function, and pathological fractures. About 50% of patients with OD or MS develop a malignancy, such as chondrosarcoma, glioma, and ovarian juvenile granulosa cell tumor. To better understand the natural history of OD and MS, we reviewed 287 papers describing patients with OD and MS. We also created a survey that was distributed directly to 162 patients through Facebook. Here, we compare the review of the cases described in the literature to the survey's responses. The review of the literature showed that: the patients with OD are diagnosed at a younger age; the prevalence of chondrosarcomas among patients with OD or MS was ~30%; in four patients, vascular anomalies were identified in internal organs only; and, the prevalence of cancer among patients with OD or MS was ~50%. With these data, health care providers will better understand the natural history, severity, and prognosis of these diseases and the prevalence of malignancies in these patients. Here, we recommend new guidelines for the care of patients with OD and MS.

摘要

奥利耶病 (OD) 和马富西综合征 (MS) 的特征是多发性内生软骨瘤。MS 患者还存在良性血管过度生长,其中 8.5%的病例会恶变为癌症。OD 的特征是多发性内生软骨瘤,通常单侧分布,以下肢附肢骨骼多见。MS 的特征是双侧多发性内生软骨瘤,大多数病例都是双侧分布。两种疾病都会导致四肢多处肿胀、关节周围畸形、关节活动受限、脊柱侧凸、骨缩短、肢体长度差异、步态异常、疼痛、功能丧失和病理性骨折。大约 50%的 OD 或 MS 患者会发展为恶性肿瘤,如软骨肉瘤、神经胶质瘤和卵巢幼年颗粒细胞瘤。为了更好地了解 OD 和 MS 的自然病程,我们复习了 287 篇描述 OD 和 MS 患者的文献。我们还直接通过 Facebook 向 162 名患者发放了一份调查问卷。在此,我们将文献中描述的病例的回顾与调查的回答进行了比较。文献回顾显示:OD 患者的诊断年龄更小;OD 或 MS 患者的软骨肉瘤患病率约为 30%;在 4 名患者中,仅在内部器官发现了血管异常;OD 或 MS 患者的癌症患病率约为 50%。有了这些数据,医疗保健提供者将更好地了解这些疾病的自然病史、严重程度和预后以及这些患者的癌症患病率。在此,我们建议为 OD 和 MS 患者制定新的护理指南。

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