Nagai S, Okuda N, Azuma H, Suzuki M, Takahama M
Department of Orthopaedic Surgery, Saitama Medical School, Japan.
Clin Orthop Relat Res. 1993 Apr(289):243-6.
A 34-year-old woman complained of pain and swelling in the left patella. Because of roentgenogram showed hardly any destruction of the patella, she was not initially treated for a bone tumor. The clinical course followed the initial symptoms of a respiratory disorder with pulmonary metastatic foci. A bone tumor was first suspected after aspiration cytology of a lung tumor mass. A left patellectomy was performed to relieve the pain and confirm the diagnosis. The pain was relieved by the operation, but respiratory failure set in and progressed rapidly. The patient died three days later. Histologic examination showed that the tumor tissue consisted of atypical cells, spindle to polygonal in shape. The marrow space of the patella was predominantly occupied by neoplastic cartilaginous tissue. The pathologic diagnosis was primary chondroblastic osteosarcoma of the patella.
一名34岁女性主诉左髌骨疼痛和肿胀。由于X线片显示髌骨几乎没有任何破坏，她最初未接受骨肿瘤治疗。临床病程最初表现为伴有肺转移灶的呼吸系统疾病症状。在对肺部肿瘤肿块进行穿刺细胞学检查后，首次怀疑为骨肿瘤。为缓解疼痛并明确诊断，进行了左髌骨切除术。手术缓解了疼痛，但随后出现呼吸衰竭并迅速进展。患者三天后死亡。组织学检查显示肿瘤组织由非典型细胞组成，形状为梭形至多边形。髌骨的骨髓腔主要被肿瘤性软骨组织占据。病理诊断为髌骨原发性软骨母细胞性骨肉瘤。
