四肢良性骨肿瘤恶变九例报告.pdfVIP

中国骨与关节杂志 2015 年 9 月第 4 卷第 9 期 Chinese Journal of Bone and Joint, September 2015, Vol 4, No.9 . 669 . . 骨肿瘤 Bone neoplasms . 四肢良性骨肿瘤恶变九例报告 肖何　丁宜　牛晓辉 DOI: 10.3969/j.issn.2095-252X.2015.09.005　　中图分类号：R738.1 作者单位：100035　北京积水潭医院骨肿瘤科 ( 肖何、牛晓辉 )，病理科 ( 丁宜 ) 通信作者：牛晓辉，Email: niuxiaohui@263.net 【摘要】　目的　报道传统上认为不会恶变或恶变很罕见的良性骨肿瘤发生恶变的病例，证明传统上认 为不会或极少恶变的病种也有恶变可能，从而丰富对骨肿瘤的认识，并为骨肿瘤的诊治提供参考。方法　查 找本中心成立以来所有住院患者的病案，从中筛选出证据明确的罕见恶变的肢体良性骨肿瘤的恶变病例，并 作报道。结果　7446 例非恶性骨肿瘤骨病中，排除骨软骨瘤、内生软骨瘤、神经纤维瘤病、骨巨细胞瘤四种 常见易恶变疾病后，四肢骨良性病变 4662 例，其罕见的恶变者 9 例，恶变比例为 0.193% ( 9 / 4662 )。发生恶 变的良性病种包括骨纤维结构不良、良性纤维性肿瘤、骨炎性病变、滑膜软骨瘤病、软骨黏液瘤、动脉瘤样 骨囊肿、软骨黏液样纤维瘤等。各病例在临床、影像、病理等角度表现出恶变特征；既往文献中提出的恶变 机制不能完全解释本组病例的恶变原因。结论　骨纤维结构不良、良性纤维性肿瘤、骨炎性病变、滑膜软骨 瘤病、软骨黏液瘤、动脉瘤样骨囊肿、软骨黏液样纤维瘤等骨肿瘤有发生恶变的可能，值得临床医师重视。 【关键词】　骨肿瘤；四肢；肿瘤，继发原发性；软骨瘤病，滑膜；骨囊肿，动脉瘤样 Report of 9 cases of malignant transformation in extremity benign bone tumors XIAO He, DING Yi, NIU Xiao- hui. Department of Orthopaedic Oncology, Beijing Jishuitan Hospital, Beijing, 100035, PRC Corresponding author: NIU Xiao-hui, Email: niuxiaohui@263.net Abstract Objective To report cases of malignant transformation of bone tumors which were conventionally 【 】 thought to be rare so as to prove the existence of malignant transformation in benign bone tumors, providing reference for clinical management of bone tumors. Methods Records of all in-patient since the establishment of our center were searched and rare cases of malignant transformation in benign bone tumors were selected. Results There were 7446 cases of non-malignant bone tumors including osteochondroma, enchondroma, neurofibromatosis, and giant cell tumors which were 4 common malignant tumor types. Nine cases of rare malignant transformation in extremity bone tumors were found out from a total o