Jundt G
Knochentumor-Referenzzentrum, Universität Basel.
Orthopade. 1995 Feb;24(1):2-14.
Benign bone tumors are frequently undiagnosed since they rarely cause pain. Based on the records of the Basle Bone Tumor Registry, which contains 2194 primary benign bone tumors, the aspects of benign bone tumors in childhood and adolescence are described. Benign bone-forming lesions like osteoid osteoma and osteoblastoma occur fairly frequently in this age group; osteofibrous dysplasia is almost exclusively seen in younger patients. Benign cartilage-forming tumors are much more cellular at this age and therefore sometimes misdiagnosed as chondrosarcomas. Chondromyxoid fibroma and especially chondroblastoma frequently occur in patients younger than 20 years. Because of their pleomorphic appearance (chondromyxoid fibroma) and their cellular composition and matrix deposition (chondroblastoma) they can be confused with chondrosarcomas, giant cell tumors or osteosarcomas. Benign fibrous histiocytoma is a very rare intraosseous fibrohistiocytic tumor that also can be found during adolescence. Since no one has much experience with this lesion, patients should be carefully monitored after complete excision. Giant cell tumors of bone reach their typical epimetaphyseal location after growth plate closure. If the physis is still open, giant cell tumors are almost exclusively found in a metaphyseal location abutting on epiphyseal cartilage. With increasing closure of the growth plate, the lesion is found most frequently in an epimetaphyseal position. The transition of a primary benign bone tumor to a sarcoma is very rare and often occurs in connection with irradiation treatment. The risk of a sarcomatous change independent of therapy is very infrequent.
良性骨肿瘤由于很少引起疼痛,常常未被诊断出来。基于巴塞尔骨肿瘤登记处包含2194例原发性良性骨肿瘤的记录,对儿童和青少年时期良性骨肿瘤的情况进行了描述。诸如骨样骨瘤和成骨细胞瘤等良性骨形成性病变在这个年龄组中相当常见;骨纤维结构不良几乎仅见于较年轻的患者。良性软骨形成性肿瘤在这个年龄段细胞更为丰富,因此有时会被误诊为软骨肉瘤。软骨黏液样纤维瘤,尤其是成软骨细胞瘤,常见于20岁以下的患者。由于其多形性外观(软骨黏液样纤维瘤)以及细胞组成和基质沉积(成软骨细胞瘤),它们可能会与软骨肉瘤、巨细胞瘤或骨肉瘤相混淆。良性纤维组织细胞瘤是一种非常罕见的骨内纤维组织细胞肿瘤,在青少年时期也可发现。由于没人对这种病变有太多经验,在完整切除后应对患者进行仔细监测。骨巨细胞瘤在生长板闭合后到达其典型的干骺端位置。如果骨骺仍未闭合,骨巨细胞瘤几乎仅见于紧邻骨骺软骨的干骺端位置。随着生长板的逐渐闭合,病变最常出现在干骺端位置。原发性良性骨肿瘤转变为肉瘤非常罕见,且常与放射治疗有关。与治疗无关的肉瘤变风险非常低。