Miyawaki T, Kinoshita Y, Iizuka T
Jikei University School of Medicine, Department of Plastic and Reconstructive Surgery, Tokyo, Japan.
Ann Plast Surg. 1997 Jan;38(1):77-80. doi: 10.1097/00000637-199701000-00015.
Enchondroma is a benign growth of cartilage arising in the bone metaphysis as a solitary or multiple primary lesions. The form of multiple enchondromatosis with unilateral predominance is termed Ollier's disease. We have recently treated a case of Ollier's disease with the chief complaint of deformity of the left hand. The patient was an 11-year-old boy. Radiographic examination showed honeycombed clear spaces in the metaphyses of the middle and proximal phalanges of the left ring and little fingers as well as of the fourth and fifth metacarpals, and thinning of the cortex of these bones, but with no evidence of pathological fracture. The tumors of the left fourth and fifth metacarpal bones and of the phalanges of the left ring and little fingers were removed, and the metacarpophalangeal joint of the little finger was capsulotomized. The patient was free from recurrence 19 months after surgery. With regard to the prognosis of Ollier's disease, malignant transformation into chondrosarcoma or osteosarcoma has been reported of the chondroma. Since Ollier's disease is self-limited in that it usually stops spontaneously as the patient grows, and since the cartilaginous lesions in occasional cases may regress or even disappear, any cartilaginous lesions that are still active or painful after termination of the growth period should be examined thoroughly under suspicion of undergoing malignant transformation.
内生软骨瘤是一种起源于骨 metaphysis 的良性软骨生长,表现为孤立性或多发性原发性病变。单侧占优势的多发性内生软骨瘤病形式称为 Ollier 病。我们最近治疗了一例以左手畸形为主诉的 Ollier 病患者。患者为一名 11 岁男孩。影像学检查显示左手环指和小指以及第四和第五掌骨的 metaphyses 有蜂窝状透亮区,这些骨骼的皮质变薄,但无病理性骨折迹象。切除了左手第四和第五掌骨以及左手环指和小指的指骨肿瘤,并对小指的掌指关节进行了关节囊切开术。患者术后 19 个月无复发。关于 Ollier 病的预后,已有报道称内生软骨瘤可恶变为软骨肉瘤或骨肉瘤。由于 Ollier 病具有自限性,通常随着患者生长而自行停止,且偶尔情况下软骨病变可能会消退甚至消失,因此在生长期结束后仍有活动或疼痛的任何软骨病变,应在怀疑发生恶性转化的情况下进行彻底检查。