Department of Trauma and Orthopaedic Surgery, Marciniak Lower Silesian Specialist Hospital, 54-049 Wroclaw, Poland.
Department of Traumatology and Emergency Medicine of Developing Age, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Int J Environ Res Public Health. 2021 Sep 3;18(17):9338. doi: 10.3390/ijerph18179338.
A suspicion of a proliferative bone lesion in a child seems to be a major diagnostic problem for clinicians. There are no diagnostic and treatment algorithms described in the literature and no reliable cohort epidemiological data. Our study was conducted among 289 paediatric patients (0-18 years old) with an initial diagnosis of a bone tumour or tumour-like lesion. The study comprised a retrospective epidemiological analysis, an assessment of the concordance of the initial diagnoses with the histopathological diagnoses and an analysis of the specific locations of the various bone lesions. The results obtained have made it possible to formulate the following conclusions. (1) The most common proliferative bone lesion in children is osteochondroma; also common are fibrous dysplasia, non-ossifying fibromas and bone cysts. (2) Verifying the initial diagnosis by means of biopsy is essential. (3) Osteochondromas are typically located in the metaphyses of long bones, fibrous dysplasia in the femur and skull, cyst-like lesions in the proximal humerus and non-osteochondral fibromas exclusively in the lower limbs. What could improve the quality of treatment for children with primary proliferative bone diseases is the establishment of centres of paediatric orthopaedic oncology skilled in early diagnosis and prompt management.
儿童骨增殖性病变的疑似病例似乎是临床医生面临的主要诊断问题。文献中没有描述诊断和治疗的算法，也没有可靠的队列流行病学数据。我们的研究是在 289 名儿科患者（0-18 岁）中进行的，这些患者最初被诊断为骨肿瘤或肿瘤样病变。该研究包括回顾性流行病学分析、评估初始诊断与组织病理学诊断的一致性以及分析各种骨病变的特定部位。所获得的结果使得能够得出以下结论。（1）儿童中最常见的增殖性骨病变是骨软骨瘤；纤维结构不良、非骨化性纤维瘤和骨囊肿也很常见。（2）通过活检验证初始诊断至关重要。（3）骨软骨瘤通常位于长骨的干骺端，纤维结构不良位于股骨和颅骨，囊肿样病变位于肱骨近端，非骨软骨纤维瘤仅位于下肢。提高儿童原发性增殖性骨病治疗质量的方法是建立熟练掌握早期诊断和及时治疗的儿科骨肿瘤学中心。
