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多学科方法用于骨膜骨肉瘤的准确诊断

Multidisciplinary approach to the accurate diagnosis of parosteal osteosarcoma.

作者信息

Kilian Miroslav, Vanatka Radovan, Tomasova Radka, Meciarova Iveta, Hlavcak Peter, Zamborsky Radoslav, Vajczikova Silvia, Tomka Miroslav

机构信息

Second Orthopedic and Traumatology Department, University Hospital Bratislava and Comenius University, Bratislava, Slovak Republic.

Trauma Surgery Clinic, University Hospital Bratislava and Slovak Medical University, Bratislava, Slovak Republic.

出版信息

Radiol Case Rep. 2025 Apr 29;20(7):3425-3435. doi: 10.1016/j.radcr.2025.04.010. eCollection 2025 Jul.

Abstract

The successful treatment of any disease depends on early and correct diagnosis. A failure to establish an accurate diagnosis can lead to ineffective, often expensive treatment and risky progression of the disease with all the negative consequences, including incurability and death. The parosteal osteosarcoma is an illustrative example of how determining the correct diagnosis can be a challenging task. Parosteal osteosarcoma is a rare malignant bone tumor, mainly affected metaphysis of long bones. It arises from cortical surface of bone and it is usually slowly growing, low-grade, and well-differentiated tumor with good prognosis. Unfortunately, parosteal osteosarcoma is often misdiagnosed as a benign osteochondroma or myositis ossificans what leads to ineffective treatment, disease progression and systemic spreading with later treatment complications. In this article, we discuss a case of 48-years-old male with prolonged diagnosis of parosteal osteosarcoma, initially misdiagnosed as myositis ossificans. The diagnosis was revised and corrected based on results obtained by various approaches, including radiography, ultrasound-guided biopsy, histology, conventional cytology, and molecular biology. On this example, we demonstrate the importance of interdisciplinary collaboration between experts from different areas of health care.

摘要

任何疾病的成功治疗都取决于早期和正确的诊断。未能做出准确的诊断可能导致治疗无效,往往费用高昂,且疾病会有危险地进展,带来所有负面后果,包括无法治愈和死亡。骨旁骨肉瘤就是一个说明确定正确诊断可能是一项具有挑战性任务的例子。骨旁骨肉瘤是一种罕见的恶性骨肿瘤,主要累及长骨的干骺端。它起源于骨的皮质表面,通常是生长缓慢、低级别且分化良好的肿瘤,预后较好。不幸的是,骨旁骨肉瘤常常被误诊为良性骨软骨瘤或骨化性肌炎,这会导致治疗无效、疾病进展和全身扩散,随后出现治疗并发症。在本文中,我们讨论了一例48岁男性患者,其骨旁骨肉瘤的诊断被拖延,最初被误诊为骨化性肌炎。基于通过各种方法获得的结果,包括放射学、超声引导下活检、组织学、传统细胞学和分子生物学,诊断得到了修正和纠正。通过这个例子,我们展示了来自不同医疗领域的专家之间跨学科合作的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bb4/12435002/eb60f43e4964/gr1.jpg

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