骨肉瘤。低级别骨内型骨肉瘤，组织学上类似于骨膜骨肉瘤、骨纤维异常增殖症和促结缔组织增生性纤维瘤。
Osteosarcoma. Low-grade intraosseous-type osteosarcoma, histologically resembling parosteal osteosarcoma, fibrous dysplasia, and desmoplastic fibroma.
作者信息
Bertoni F, Bacchini P, Fabbri N, Mercuri M, Picci P, Ruggieri P, Campanacci M
机构信息
Istituto Ortopedico Rizzoli, Bologna, Italy.
出版信息
Cancer. 1993 Jan 15;71(2):338-45. doi: 10.1002/1097-0142(19930115)71:2<338::aid-cncr2820710212>3.0.co;2-h.
BACKGROUND
Low-grade intraosseous osteosarcoma is a rare variety of osteosarcoma and it is difficult to recognize.
METHODS
A series of 10 patients with low-grade intraosseous osteosarcoma is reported. These patients were identified from the Istituto Rizzoli files, which includes approximately 1000 cases of osteosarcoma. Clinical data and radiographic and histologic features were studied.
RESULTS
The radiographic appearance confirmed malignancy in five patients and suggested it in two. A benign lesion was diagnosed in three patients. Three lesions resembled parosteal osteosarcoma, two appeared similar to fibrous dysplasia, and two had features of desmoplastic fibroma. A mixed histologic pattern was found in three other tumors. Recurrence after intralesional excision in all patients indicated the aggressive nature of this lesion. The development of metastases in two patients and progression in the grade of malignancy in one of these highlighted the malignant nature of the tumor.
CONCLUSIONS
The correct diagnosis would permit adequate treatment with wide surgical margins.
背景
低度骨内骨肉瘤是骨肉瘤的一种罕见类型，难以识别。
方法
报告了10例低度骨内骨肉瘤患者。这些患者来自里佐利研究所的病例档案，该档案包含约1000例骨肉瘤病例。对临床资料以及影像学和组织学特征进行了研究。
结果
影像学表现确诊5例为恶性，2例提示为恶性。3例诊断为良性病变。3个病变类似骨旁骨肉瘤，2个类似纤维发育不良，2个具有促纤维增生性纤维瘤的特征。另外3个肿瘤发现有混合组织学模式。所有患者经病灶内切除后复发，表明该病变具有侵袭性。2例发生转移，其中1例恶性程度进展，突出了肿瘤的恶性本质。
结论
正确诊断有助于采用具有足够手术切缘的适当治疗方法。
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