Barlow I W, Newman R J
Academic Unit of Orthopaedic Surgery, St James's University Hospital, Leeds, UK.
J R Coll Surg Edinb. 1994 Feb;39(1):51-4.
An audit of the prospectively gathered data of the Leeds Regional Bone Tumour Registry found that primary bone tumours of the shoulder constituted 145 of 2039 cases (7%). Seventy-five per cent of these occurred in the proximal humerus, 20% in the scapula and 5% in the outer half of the clavicle. Malignant and benign tumours were of equal overall frequency (73 vs 72) but the malignant lesions tended to occur in an older population (mean ages 43 years and 17 years respectively). Simple bone cyst was the commonest diagnosis in children, chondrosarcoma in the middle age group and osteosarcoma in the over-60s. Presenting symptoms were a poor guide to whether the lesion was malignant or not and the correct preoperative diagnosis was made only in a minority of cases. In 134 cases the diagnosis made by the referring pathologist was confirmed by the Bone Tumour Registry but in 11 cases, the diagnosis was changed by the Tumour Registry and differed with important clinical implications. Bone tumour registries provide a valuable source of cumulative information about uncommon tumours and facilitate accurate diagnosis, teaching and research.
对利兹地区骨肿瘤登记处前瞻性收集的数据进行的一项审计发现,肩部原发性骨肿瘤占2039例中的145例(7%)。其中75%发生在肱骨近端,20%发生在肩胛骨,5%发生在锁骨外半段。恶性肿瘤和良性肿瘤的总体发生率相同(分别为73例和72例),但恶性病变往往发生在年龄较大的人群中(平均年龄分别为43岁和17岁)。单纯性骨囊肿是儿童最常见的诊断,软骨肉瘤在中年组,骨肉瘤在60岁以上人群中最常见。症状对于判断病变是否为恶性帮助不大,只有少数病例能做出正确的术前诊断。在134例病例中,转诊病理学家做出的诊断得到了骨肿瘤登记处的确认,但在11例病例中,肿瘤登记处改变了诊断,且这种改变具有重要的临床意义。骨肿瘤登记处提供了有关罕见肿瘤的宝贵累积信息来源,有助于准确诊断、教学和研究。