Kattapuram A S, O'Donnell R J, Huszar M, Rosenberg A E, Kattapuram S V, Mankin H J
Orthopaedic Oncology Unit, Massachusetts General Hospital, Boston, USA.
Clin Orthop Relat Res. 1996 Aug(329):281-7. doi: 10.1097/00003086-199608000-00035.
The surgical outcome for innominate giant cell tumors was reviewed in 7 patients; 6 (86%) were female patients and 1 (14%) was a male patient. The patients had an average age of 28.7 years (range, 16-42 years) and an average followup of 4.6 years (range, 2.0-7.3 years). Three tumors were in the ischiopubic region, 3 were acetabular, and 1 was iliosacral. The tumors ranged in size from 5 cm x 6 cm to 17 cm x 18 cm. All margins were intralesional. Reconstruction in 3 cases used osteoarticular acetabular allografts. The local recurrence rate was 3 of 7 (43%). Ischiopubic tumors accounted for all recurrences. Vascular invasion was seen in all patients who had a recurrence and only 1 patient without a recurrence. Patients with recurrences underwent subsequent resections and radiation therapy, and remain disease free at an average followup of 3.0 years (range, 0.8-4.2 years) after recurrence. There were no malignant, metastatic, or multicentric recurrences, and no patient died of disease or complications. Innominate giant cell tumor occurs most often in women and is associated with a high risk for local recurrence. Wide margins usually are not possible; intralesional margins are accepted in cases of limited accessibility or potential functional compromise.
对7例无名骨巨细胞瘤患者的手术结果进行了回顾性分析；其中6例（86%）为女性患者，1例（14%）为男性患者。患者的平均年龄为28.7岁（范围16 - 42岁），平均随访时间为4.6年（范围2.0 - 7.3年）。3例肿瘤位于耻骨坐骨区域，3例位于髋臼，1例位于髂骨骶骨。肿瘤大小范围为5 cm×6 cm至17 cm×18 cm。所有切缘均为瘤内切缘。3例患者的重建采用了骨关节髋臼异体骨移植。局部复发率为7例中的3例（43%）。所有复发均为耻骨坐骨肿瘤。在所有复发患者以及仅1例未复发患者中均可见血管侵犯。复发患者随后接受了再次手术和放疗，复发后平均随访3.0年（范围0.8 - 4.2年）时仍无疾病复发。未出现恶性、转移性或多中心复发，也没有患者死于疾病或并发症。无名骨巨细胞瘤最常发生于女性，且局部复发风险较高。通常无法实现广泛切缘；在手术入路受限或可能导致功能受损的情况下，瘤内切缘是可以接受的。
