Krauspe R
Orthopädische Klinik, König-Ludwig-Haus, Julius-Maximilians-Universität, Würzburg.
Orthopade. 1995 Feb;24(1):29-36.
Chondromas are benign tumors characterized by the formation of mature cartilage. Typically, they involve the short bones of the hands and feet. The lesions may be either solitary or multiple as part of enchondromatosis affecting several bones. Cases of multiple enchondromatosis with predominantly unilateral distribution are generally referred to as "Ollier's disease" or when accompanied by multiple hemangiomas as "Maffucci's syndrome". In cases with multiple chondromas there is considerable risk of malignant transformation (approximately 50%). Treatment of single lesions (curettage and bone grafting) is usually uneventful, but any therapeutic approach to Ollier's disease or Maffucci's syndrome should be tailored to the individual distribution of lesions in the most severely deformed extremities. Chondroblastomas are uncommon benign tumors that are almost invariably situated in the epiphyses of long bones adjacent to the epiphyseal cartilage plate. Histologically, they are characterized by round or polygonal chondroblasts with focal accumulation of osteoclast-like giant cells. Intercellular substance is scanty, and calcification occurs typically at focal areas. Lung metastases are reported in rare single cases with high survival rates after local resection, indicating low-grade malignancy. Only a few recurrences have been reported following curettage and bone grafting. Avascular necrosis or chondrolysis with subsequent secondary osteoarthrosis may occur after surgical treatment of chondroblastoma of the upper femur epiphysis. These severe indirect sequelae should be considered both when planning surgery and during follow-up. Chondromyxoid fibromas are rare benign tumors that are mostly diagnosed in the second and third decade; they are mainly found in the proximal tibial metaphysis. Histologically, there are areas of chondroid, myxoid, and fibrotic tissues, of which the myxoid component is characteristic for chondromyxoid fibromas.(ABSTRACT TRUNCATED AT 250 WORDS)
软骨瘤是一种以成熟软骨形成为特征的良性肿瘤。通常,它们累及手和脚的短骨。病变可以是单发的,也可以是多发的,后者是内生软骨瘤病累及多根骨头的表现。以单侧分布为主的多发内生软骨瘤病病例通常称为“Ollier病”,若伴有多发血管瘤则称为“Maffucci综合征”。多发软骨瘤病例存在相当高的恶变风险(约50%)。单发病变的治疗(刮除术和骨移植)通常顺利,但对Ollier病或Maffucci综合征的任何治疗方法都应根据最严重畸形肢体中病变的个体分布情况量身定制。软骨母细胞瘤是罕见的良性肿瘤,几乎总是位于长骨骨骺靠近骨骺软骨板处。在组织学上,它们的特征是圆形或多边形的软骨母细胞,伴有破骨细胞样巨细胞的局灶性聚集。细胞间物质稀少,钙化通常发生在局灶区域。罕见的单发病例有肺转移报道,局部切除后生存率高,提示恶性程度低。刮除术和骨移植后仅有少数复发报道。股骨上端骨骺软骨母细胞瘤手术治疗后可能发生无血管坏死或软骨溶解,继发继发性骨关节炎。在规划手术和随访期间都应考虑到这些严重的间接后遗症。软骨黏液样纤维瘤是罕见的良性肿瘤,大多在第二和第三个十年被诊断出来;主要见于胫骨近端干骺端。在组织学上,有软骨样、黏液样和纤维组织区域,其中黏液样成分是软骨黏液样纤维瘤的特征。(摘要截取自250字)