Ferguson P C, Griffin A M, Bell R S
Department of Surgery, University of Toronto, Canada.
Clin Orthop Relat Res. 1997 Mar(336):199-204. doi: 10.1097/00003086-199703000-00028.
Eight cases of primary tumors of the patella were identified in a consecutive series of 587 patients treated surgically for benign or malignant bone tumors. Six cases were benign (5 giant cell tumors and 1 chondroblastoma), and there were 2 malignant tumors (osteosarcoma and malignant fibrous histiocytoma). Both patients with malignant lesions had Rothmund-Thomson syndrome. Benign pulmonary metastases developed in 2 of the patients with giant cell tumor and 1 patient now is deceased 72 months after surgery. Two patients were treated before referral to a tertiary care center; 1 with patellectomy before histologic diagnosis and 1 with curettage. Both resulted in extension of disease into the knee joint. Tumors of the patella require careful assessment before surgical management. Conservation of the bone can be achieved in benign lesions that have adequate residual bone remaining at the articular surface. Conservation of the extremity is possible in malignant tumors, but reconstruction of the extensor mechanism is difficult.
在连续587例接受手术治疗的良性或恶性骨肿瘤患者中，发现了8例髌骨原发性肿瘤。6例为良性（5例骨巨细胞瘤和1例软骨母细胞瘤），2例为恶性肿瘤（骨肉瘤和恶性纤维组织细胞瘤）。两名患有恶性病变的患者均患有罗思蒙德-汤姆森综合征。2例骨巨细胞瘤患者出现了良性肺转移，1例患者在手术后72个月死亡。两名患者在转诊至三级护理中心之前就已接受治疗；1例在组织学诊断前接受了髌骨切除术，1例接受了刮除术。两者均导致疾病扩展至膝关节。髌骨肿瘤在手术治疗前需要仔细评估。对于关节面仍有足够残余骨的良性病变，可以实现保骨。对于恶性肿瘤，保肢是可能的，但伸肌机制的重建很困难。
