Bertoni F, Present D, Enneking W F
J Bone Joint Surg Am. 1985 Jul;67(6):890-900.
We reviewed the cases of seven patients with histologically benign primary giant-cell tumor of bone and histologically proved metastases to the lung. All seven had a Stage-3, aggressive, benign lesion with interruption of the cortex and soft-tissue extension. The main histological features of the primary lesion were identical to those of the pulmonary metastases. In only one of the seven patients were the metastases detected simultaneously with the primary lesion. All seven patients were treated by surgical resection of the lung nodules and chemotherapy. Of the seven patients, four were alive and free of disease after an average follow-up of nine years; two were receiving chemotherapy; and one, who had had immunosuppression for an allograft transplant, died less than one year after the discovery of the pulmonary lesions. Based on this small series, we concluded that patients with a Stage-3 giant-cell tumor of bone may be at risk for pulmonary spread of the disease. This lesion, with its benign histological picture even in lung lesions, has a favorable prognosis when treated with pulmonary resection of the nodules. However, the role for chemotherapy after pulmonary surgery is still unclear.
我们回顾了7例组织学上为骨原发性良性巨细胞瘤且经组织学证实有肺转移的患者病例。所有7例均为3期侵袭性良性病变，伴有皮质中断和软组织浸润。原发病变的主要组织学特征与肺转移灶相同。7例患者中只有1例在发现原发病变的同时检测到转移灶。所有7例患者均接受了肺结节手术切除及化疗。7例患者中，4例在平均9年的随访后存活且无疾病；2例正在接受化疗；1例因同种异体移植接受免疫抑制治疗，在发现肺部病变后不到1年死亡。基于这个小样本系列，我们得出结论，3期骨巨细胞瘤患者可能有疾病肺转移的风险。即使在肺部病变中其组织学表现为良性，该病变经肺结节切除术后预后良好。然而，肺手术后化疗的作用仍不明确。
