Sato K, Yamamura S, Iwata H, Sugiura H, Nakashima N, Nagasaka T
Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan.
Nagoya J Med Sci. 1996 Dec;59(3-4):151-7.
This report discusses a rare case of giant cell-rich osteosarcoma. The patient, a 19-year-old male, was diagnosed with a metadiaphyseal osteolytic lesion when he consulted a local doctor complaining of motion pain without swelling. Radiography revealed a geographic osteolytic lesion, cortical thinning and ballooning without obvious cortical destruction. However, a fine onion skin-like periosteal reaction was observed on the lateral side of the femur. The transitional none was narrow and endosteal scalloping was also noted. Needle biopsied material clearly showed nuclear atypism of the stromal tumor cells with numerous osteoclast-like giant cells. Using a combination of pathological examination, radiography, computed tomography (CT) and magnetic resonance imaging (MRI), a diagnosis of giant cell-rich osteosarcoma was reached. After chemotherapy, resection and limb salvage surgery with an autogeneous autoclaved bone graft, a vascularized fibular graft were performed, and the patient has shown excellent limb function without local recurrence or distant metastasis during the past 72 months.
本报告讨论了一例罕见的富含巨细胞的骨肉瘤病例。患者为一名19岁男性，因主诉活动时疼痛但无肿胀而咨询当地医生，被诊断为干骺端溶骨性病变。X线检查显示为地图样溶骨性病变，皮质变薄和膨胀，无明显皮质破坏。然而，在股骨外侧观察到细微的葱皮样骨膜反应。移行带狭窄，也可见骨内膜扇贝样改变。针吸活检材料清楚显示间质肿瘤细胞核异型性，伴有大量破骨细胞样巨细胞。结合病理检查、X线检查、计算机断层扫描（CT）和磁共振成像（MRI），确诊为富含巨细胞的骨肉瘤。化疗后，进行了切除及肢体挽救手术，采用自体高压灭菌骨移植和带血管腓骨移植，在过去72个月里，患者肢体功能良好，无局部复发或远处转移。
