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未进行活检成功切除股骨头透明细胞软骨肉瘤:一例报告。

Successful resection for femoral head clear cell chondrosarcoma without biopsy: A case report.

作者信息

Hoshi Manabu, Oebisu Naoto, Ohta Yoichi, Tomimoto Ayaka, Nakamura Hiroaki

机构信息

Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.

出版信息

Mol Clin Oncol. 2022 Feb;16(2):26. doi: 10.3892/mco.2021.2459. Epub 2021 Dec 7.

Abstract

Clear cell chondrosarcoma (CCCS) is a rare, low-grade, malignant chondrogenic bone tumour. This tumour commonly affects the epiphysis of long bones, particularly in the proximal femur. The present study reported on the case of a 58-year-old male with right hip pain of five months duration. Plain radiography, magnetic resonance imaging and computed tomography scan revealed the characteristic appearance of chondroid mineralisation in the right femoral head, suggesting typical CCCS. Although biopsy is the gold standard for definite diagnosis prior to treatment, wide resection with removal of the biopsy tract is thought to negatively affect the surgical margin and postoperative hip function. Therefore, resection without any biopsy and a hip hemiarthroplasty were performed. The pathological diagnosis was CCCS and an adequate surgical margin was obtained. No local recurrence or distant metastases were detected and postoperative function was excellent at the final follow-up. The femoral head is a typical location of CCCS. Wide resection with adequate margins is the main treatment strategy for CCCS and when radiological features are typical, resection without a biopsy is an acceptable treatment option to improve patient outcomes.

摘要

透明细胞软骨肉瘤(CCCS)是一种罕见的、低度恶性的软骨源性骨肿瘤。这种肿瘤通常累及长骨的骨骺,尤其是股骨近端。本研究报告了一例58岁男性,右髋部疼痛持续5个月。X线平片、磁共振成像和计算机断层扫描显示右股骨头有软骨样矿化的特征性表现,提示典型的CCCS。尽管活检是治疗前明确诊断的金标准,但广泛切除并切除活检通道被认为会对手术切缘和术后髋关节功能产生负面影响。因此,未进行任何活检即进行了切除和髋关节半关节置换术。病理诊断为CCCS,获得了足够的手术切缘。在最后随访时未发现局部复发或远处转移,术后功能良好。股骨头是CCCS的典型发病部位。具有足够切缘的广泛切除是CCCS的主要治疗策略,当影像学特征典型时,不进行活检的切除是改善患者预后的可接受治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4057/8719253/e5688c9409bd/mco-16-02-02459-g00.jpg

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