Mahdal Michal, Apostolopoulos Vasileios, Pazourek Lukáš, Staniczková Zambo Iva, Adámková Dagmar, Múdry Peter, Zoufalý Dušan, Tomáš Tomáš
First Department of Orthopaedic Surgery, St. Anne's University Hospital, 60200 Brno, Czechia.
Faculty of Medicine, Masaryk University, 62500 Brno, Czechia.
Oncol Lett. 2024 Nov 12;29(1):54. doi: 10.3892/ol.2024.14800. eCollection 2025 Jan.
Hand and foot osteosarcoma represents ~1% of all diagnosed cases of osteosarcoma. The rarity of osteosarcoma of the hand and foot leads to frequent misdiagnosis, delayed diagnosis or incorrect treatments, which can lead to fatal consequences. Typically, salvaging the affected limb is the treatment of choice, and with the use of chemotherapy, 60-65% of patients with osteosarcoma can be treated without amputation. Due to its rarity, misdiagnosis and treatment delays are common, yet detailed reviews and analyses of such cases are limited. The present retrospective cohort study aimed to review and analyze cases of osteosarcoma located in the hand and foot. From January 2007 to January 2019, 11 patients were treated at the Masaryk Memorial Cancer Institute Sarcoma Center (Brno, Czechia), 5 cases affected the hand and 6 affected the foot. A total of 6 male patients and 5 female patients, with a mean age of 30.9±16.74 years, were diagnosed with hand or foot osteosarcoma. The mean follow-up period was 90.36±66.14 months. The mean tumor size detected during diagnosis was 4.29±1.81 cm. Osteoblastic osteosarcoma was the most common histopathological type, accounting for 4 cases (33.4%). A majority of the osteosarcomas were identified as high grade (81.8%). A total of 5 patients experienced misdiagnoses following their initial biopsy, with 2 patients initially receiving treatment outside the Masaryk Memorial Cancer Institute Sarcoma Center. The most frequently encountered misdiagnosis was giant-cell tumor of the bone. A total of 3 patients underwent limb amputation and 2 patients developed lung metastasis and succumbed to the disease. The disease-free survival period and overall survival rate were calculated using Kaplan-Meier survival analysis. The mean disease-free survival period was 82.83±60.05 months, while the overall survival rate was 72%, with a mean survival time of 90.36±56.73 months. In summary, an examination of a case series involving 11 patients diagnosed with osteosarcoma of the hand and foot was conducted. The treatment approach, clinical characteristics and patient outcomes were described. A total of four case studies of patients with osteosarcoma in the hand or foot were presented. Misdiagnosis of this disease may result in the inappropriate treatment being administered to patients, therefore, the correct and rapid diagnosis of disease is necessary for effective treatment of hand and foot osteosarcomas.
手足骨肉瘤约占所有确诊骨肉瘤病例的1%。手足骨肉瘤较为罕见，常导致误诊、诊断延迟或治疗不当，进而可能引发致命后果。通常，保肢治疗是首选方案，使用化疗后，60% - 65%的骨肉瘤患者无需截肢即可接受治疗。由于其罕见性，误诊和治疗延迟很常见，但对此类病例的详细综述和分析却很有限。本回顾性队列研究旨在对手足骨肉瘤病例进行综述和分析。2007年1月至2019年1月，11例患者在马萨里克纪念癌症研究所肉瘤中心（捷克布尔诺）接受治疗，其中5例手部受累，6例足部受累。共有6例男性患者和5例女性患者被诊断为手足骨肉瘤，平均年龄为30.9±16.74岁。平均随访期为90.36±66.14个月。诊断时检测到的肿瘤平均大小为4.29±1.81厘米。成骨细胞性骨肉瘤是最常见的组织病理学类型，占4例（33.4%）。大多数骨肉瘤被确定为高级别（81.8%）。共有5例患者在初次活检后被误诊，其中2例患者最初在马萨里克纪念癌症研究所肉瘤中心以外接受治疗。最常遇到的误诊是骨巨细胞瘤。共有3例患者接受了截肢手术，2例患者发生肺转移并死于该病。采用Kaplan - Meier生存分析计算无病生存期和总生存率。平均无病生存期为82.83±60.05个月，总生存率为72%，平均生存时间为90.36±56.73个月。总之，对11例被诊断为手足骨肉瘤的患者进行了病例系列研究。描述了治疗方法、临床特征和患者预后。共展示了4例手足骨肉瘤患者的病例研究。该病的误诊可能导致对患者进行不恰当的治疗，因此，正确快速地诊断疾病对于有效治疗手足骨肉瘤至关重要。
