Bjornsson J, Unni K K, Dahlin D C, Beabout J W, Sim F H
Am J Surg Pathol. 1984 Mar;8(3):223-30. doi: 10.1097/00000478-198403000-00009.
Clear cell chondrosarcoma of bone, a low-grade malignant tumor, frequently presents diagnostic difficulties. Its clinical, roentgenographic, and pathologic characteristics separate it from conventional chondrosarcoma and, more importantly, from several benign bone tumors with which it is often confused. This report analyzes 47 cases seen at the Mayo Clinic and in consultation. The lesion is more common in males than females (2.6:1) and has a predilection for the end of long bones, particularly the proximal femur. The age range is wide; most patients are in the third and fourth decades of life. Roentgenographically, the lesion most often is purely lytic and slightly expansile, with a sharp margin between the tumor and the adjacent normal bone. Pathologically, clear cells arranged in an indistinct lobular pattern characterize the tumor. Frequently, areas mimicking other primary bone tumors, benign and malignant, are present, often to such an extent as to obscure the true identity of the process. The overall mortality in the present series was 15%. En bloc resection, including a margin of normal bone and soft tissue, appears to be the treatment of choice.
骨透明细胞软骨肉瘤是一种低度恶性肿瘤，常给诊断带来困难。其临床、X线及病理特征使其有别于传统软骨肉瘤，更重要的是，有别于一些常与之混淆的良性骨肿瘤。本报告分析了梅奥诊所所见及会诊的47例病例。该病变男性比女性更常见（2.6:1），好发于长骨末端，尤其是股骨近端。发病年龄范围广；大多数患者处于第三和第四个十年。X线表现上，病变最常见的是单纯溶骨性且轻度膨胀性，肿瘤与相邻正常骨之间界限清晰。病理上，肿瘤的特征是透明细胞呈不明显的小叶状排列。通常，存在模仿其他原发性骨肿瘤（良性和恶性）的区域，其程度常常足以掩盖病变的真实性质。本系列的总死亡率为15%。整块切除，包括正常骨和软组织边缘，似乎是首选的治疗方法。
