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酷似良性炎症过程的软组织肉瘤:诊断难题

Soft Tissue Sarcomas Mimicking Benign Inflammatory Processes: A Diagnostic Dilemma.

作者信息

Furtado Cleofina, Zeitoun Rania, Wilkes Jonathan, Sumathi Vaiyapuri, Tony George

机构信息

Department of Diagnostic and Interventional Radiology, University Hospitals of North, Midlands NHS Trust, Stoke on Trent, United Kingdom.

Department of Diagnostic and Interventional Radiology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

Mediterr J Rheumatol. 2023 Aug 27;34(4):531-536. doi: 10.31138/mjr.270823.sts. eCollection 2023 Dec.

Abstract

BACKGROUND

Soft tissue sarcomas are rare and often go undetected until a later stage, particularly when they present as intra-articular or tenosynovial lesions mimicking benign synovial pathologies. The failure to distinguish between malignant and benign synovial disease can have a significant impact on patient outcomes and limit alternatives for local control surgery and limb salvage.

CASE DESCRIPTION

In this case series, we present two cases of soft tissue sarcomas, one being an intraarticular synovial chondrosarcoma, and the other a pleomorphic spindle cell sarcoma centred along tendon sheaths. Radiologically, the initial clinical presentation of these cases resembled benign synovial pathologies, leading to a delay in diagnosis and treatment.

CONCLUSION

Our study underscores the importance of maintaining a low threshold of suspicion for surveillance, a multidisciplinary approach, and early histological diagnosis to ensure appropriate timely treatment and a favourable prognosis for patients with soft tissue sarcomas.

摘要

背景

软组织肉瘤较为罕见,通常在较晚阶段才被发现,尤其是当它们表现为模仿良性滑膜病变的关节内或腱鞘滑膜病变时。无法区分恶性和良性滑膜疾病会对患者的治疗结果产生重大影响,并限制局部控制手术和肢体挽救的选择。

病例描述

在本病例系列中,我们展示了两例软组织肉瘤,一例是关节内滑膜软骨肉瘤,另一例是沿腱鞘分布的多形性梭形细胞肉瘤。在放射学上,这些病例最初的临床表现类似于良性滑膜病变,导致诊断和治疗延迟。

结论

我们的研究强调了对监测保持低怀疑阈值、采用多学科方法以及进行早期组织学诊断的重要性,以确保对软组织肉瘤患者进行适当的及时治疗并获得良好的预后。

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