Li B, Mei F R, Wang J H
Xinqiao Hospital, Third Military Medical College, Chongaing.
Zhonghua Zhong Liu Za Zhi. 1988 May;10(3):236-8.
From March 1966 to June 1985, 9 patients with humerus malignant tumor were treated by en-bloc resection and immediate reconstruction. There were 5 males and 4 females. The ages ranged from 18 to 74 with an average of 38.3 years. These 9 lesions were diagnosed by pathology as malignant giant cell tumor of the bone (2), chondrosarcoma (2), reticulum cell sarcoma (1), osteoblastoma (osteosarcomatous) (1), osteogenic sarcoma (1) and metastatic cancer (1) clear cell cancer and 1 thyroid cancer), located either in the upper or lower end of the humerus. Cutting margin was 4-7 cm from the tumor. The length of resected humerus was 10-18 cm. Simple excision without reconstruction was done only in 1 patient. The bone defect after resection was reconstructed with autogenous fibular graft in 3 patients, replantation of the limb in 2, one of whom was added with prosthesis for reconstruction of the elbow function, humerus prosthesis in 2 and elbow prosthesis in 1. All the patients were followed. Only two had died and 7 are still alive without evidence of disease. The longest survival was 20.5 years and the shortest, 18 months with an average of 10.1 years. The causes of death (1 osteoblastoma and 1 osteogenic sarcoma) were recurrence and lung metastasis. The indication, extent of excision and causes of recurrence are discussed.
1966年3月至1985年6月，对9例肱骨恶性肿瘤患者行整块切除并即刻重建治疗。其中男性5例，女性4例。年龄18～74岁，平均38.3岁。这9例病变经病理诊断为骨恶性巨细胞瘤（2例）、软骨肉瘤（2例）、网状细胞肉瘤（1例）、成骨细胞瘤（骨肉瘤样）（1例）、骨肉瘤（1例）及转移性癌（1例透明细胞癌和1例甲状腺癌），均位于肱骨上端或下端。切缘距肿瘤4～7cm。切除的肱骨长度为10～18cm。仅1例患者行单纯切除未重建。3例患者切除后骨缺损采用自体腓骨移植重建，2例肢体再植，其中1例加用假体重建肘关节功能，2例采用肱骨假体，1例采用肘关节假体。所有患者均获随访。仅2例死亡，7例仍存活，无疾病证据。最长生存20.5年，最短18个月，平均10.1年。死亡原因（1例成骨细胞瘤和1例骨肉瘤）为复发和肺转移。文中讨论了手术适应证、切除范围及复发原因。
