Szendröi M, Rényi-Vámos A, Marschalkó P, Minik K, Kiss A L
Semmelweis OTE Ortopédiai Klinika, Budapest.
Magy Traumatol Ortop Kezseb Plasztikai Seb. 1994;37(1):37-44.
Authors report on the long time (in average 12 years, range: 5-36 years) follow-up results of 5 cases of adamantinoma, localized on the tibia. In one case recurrence was found very late, 20 and 36 years after the primary wide resection, and resection was repeatedly performed. Because of problems of differential diagnosis in one case the tumor was excised intralesionally (curettage + plasty with cancellous bone). 7 years later the persistence of the process was found only. 1 patient died in consequence of pulmonary metastasis 9 years after the primary operation. Wide resection is suggested both for the removal of the primary tumor and the recurrences, appearing very late. For the reconstruction of the bone autologous fibula is proposed. Adamantinoma is thought to be a low malignity tumor, the outcome of which cannot be predicted from the clinical and histological findings. Considering the late recurrences and metastasis a long range, minimally 10 years, following of the patient is thought to be necessary.
作者报告了5例胫骨骨样骨瘤的长期(平均12年,范围:5 - 36年)随访结果。1例复发很晚,在初次广泛切除术后20年和36年,且反复进行了切除。由于1例存在鉴别诊断问题,肿瘤采用病灶内切除(刮除 + 松质骨成形术)。7年后仅发现病情持续存在。1例患者在初次手术后9年因肺转移死亡。建议对原发性肿瘤及很晚出现的复发灶均进行广泛切除。对于骨重建,建议采用自体腓骨。骨样骨瘤被认为是一种低恶性肿瘤,其预后无法根据临床和组织学表现预测。考虑到晚期复发和转移,认为对患者进行至少10年的长期随访是必要的。