chondroma

软骨瘤
  • 文章类型: Journal Article
    骨外软骨瘤是不附着于骨骼或骨膜的小结节性软骨病变。它们是罕见的肿瘤,通常发生在手和脚。本研究的目的是描述左膝骨外肌内软骨瘤(EIC)的病例以及我们面临的诊断挑战。一名25岁的女性患者表现为左膝肿胀缓慢增长2年。临床上,肿胀是由股四头肌引起的。我们考虑了横纹肌瘤等可能性,神经纤维瘤,和肌内脂肪瘤.影像学检查提示良性脂肪瘤。她接受了切除治疗。显微镜检查与EIC一致,无复发。一个罕见的实体,临床上,EIC可以模拟其他良性软组织肿瘤。组织病理学检查可以提供明确的诊断。切除肿瘤是治愈性的。
    Extraskeletal chondromas are small nodular cartilaginous lesions not attached to bone or the periosteum. They are rare tumors commonly occurring in the hands and feet. The objective of the present study is to describe a case of extraskeletal intramuscular chondroma (EIC) in the left knee and the diagnostic challenges faced by us. A 25-year-old female patient presented with slow-growing swelling in the left knee for 2 years. Clinically, the swelling was arising from the quadriceps muscle. We considered possibilities such as rhabdomyoma, neurofibroma, and intramuscular lipoma. Imaging studies suggested a benign fatty tumor. She was treated by excision. Microscopy was consistent with EIC without recurrence. A rare entity, clinically, EIC can mimic other benign soft-tissue tumors. Histopathology exams can provide a definitive diagnosis. The excision of the tumor is curative.
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  • 文章类型: Review
    鼻软骨瘤和鼻非典型软骨肿瘤(或1级软骨肉瘤)是非常罕见的软骨源性肿瘤。已描述了大约150例鼻软骨瘤和少于50例的鼻非典型软骨肿瘤。我们报告了1例右侧筛窦区域的鼻软骨瘤和1例前间隔的鼻非典型软骨肿瘤。内镜下切除后17年无软骨瘤复发。通过面部中部脱套广泛手术切除36个月后,鼻腔非典型软骨肿瘤复发。通过面部中部脱套再次进行了翻修手术。鼻软骨瘤和非典型软骨肿瘤的复发极为罕见。目前的数据表明有足够的手术切除,在某些情况下甚至激进,作为避免复发的最重要参数。对于不能手术的非典型软骨肿瘤复发病例,可以观察。
    Nasal chondromas and nasal atypical cartilaginous tumors (or chondrosarcoma grade 1) are very rare chondrogenic tumors. Approximately 150 cases of nasal chondroma and fewer than 50 cases of nasal atypical cartilaginous tumors have been described. We reported a case with nasal chondroma in the right ethmoid area and a case with a nasal atypical cartilaginous tumor of the anterior septum. No chondroma recurrence was noted for 17 years after endoscopic resection. Recurrence was noted for the nasal atypical cartilaginous tumor 36 months after wide surgical excision via midfacial degloving. Revision surgery was performed again via midfacial degloving. Recurrences of nasal chondroma and atypical cartilaginous tumors are extremely rare. The current data indicate adequate surgical excision, in some cases even radical, as the most important parameter to avoid recurrence. For inoperable recurrent cases of atypical cartilaginous tumors, observation may be followed.
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  • 文章类型: Review
    背景:本研究旨在观察中期临床,使用骨镜辅助刮除和人工骨替代物或骨移植治疗的手部内生软骨瘤患者的功能和放射学结果。骨镜检查的添加允许在肿瘤组织刮除期间和之后直接可视化骨腔,而无需在骨皮质中形成大开口。这可以更好地清除肿瘤组织并降低医源性骨折的风险。方法:回顾性分析2013年12月至2020年11月收治的11例手术患者的临床资料。所有病例均有内生软骨瘤的组织学诊断。排除随访期少于3个月的患者。平均随访时间为20.9个月。对于临床结果,我们测量了总主动运动(TAM),并根据Belsky评分握力进行评分。对于功能结果,手臂的快速残疾,使用肩手问卷(QuickDASH)评分。对于放射学结果,我们评估了X线对骨腔充盈缺损,根据Tordai提出的系统,新骨形成。结果:患者的平均TAM为257º。共有60%的患者Belsky评分为优秀,40%患者Belsky评分分级良好。与对侧相比,握力的平均百分比为86.2%。QuickDASH平均得分为7.7。对于患者的伤口美学评级,81.8%的患者报告为优秀。对于放射学结果,所有患者术后X线片显示骨充填缺损小于3mm。完成骨巩固的平均时间为3.8个月。没有患者显示任何复发的放射学迹象。结论:我们的研究表明,用这种微创方法治疗的手部内生软骨瘤患者表现出良好的功能和放射学结果。它的应用还可以扩展到治疗手中的其他良性骨病变。证据级别:IV级(治疗)。
    Background: This study aims to look at the intermediate-term clinical, functional and radiological outcomes of patients with enchondroma in hand treated with osteoscopic-assisted curettage and artificial bone substitute or bone graft. The addition of osteoscopy allows direct visualisation of the bone cavity during and after curettage of tumour tissue without the need of creating a large opening in the bone cortex. This could lead to better clearance of tumour tissue and lower risk of iatrogenic fracture. Methods: A total of 11 patients who received surgery from December 2013 to November 2020 were retrospectively reviewed. All cases had histological diagnosis of enchondroma. Patients with a follow-up period of less than 3 months were excluded. The mean duration of follow-up was 20.9 months. For the clinical outcome, we measured the total active motion (TAM) and graded with Belsky score grip strength. For the functional outcome, the Quick Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH) score was used. For the radiological outcome, we evaluated the X-ray for bone cavity filling defect, new bone formation according to the system proposed by Tordai. Results: The mean TAM of patients was 257º. A total of 60% patients had Belsky score grading excellent, 40% patients had Belsky score grading good. The mean percentage of grip strength compared with the contralateral side was 86.2%. The mean QuickDASH score was 7.7. For the wound aesthetic rating by patients, 81.8% patients reported as excellent. For the radiological outcome, the postoperative X-ray of all patients showed bone filling defect less than 3 mm. The mean time to complete bone consolidation was 3.8 months. None of the patients showed any radiological signs of recurrence. Conclusions: Our study showed that patients with enchondromas in hand treated with this minimally invasive method demonstrated good functional and radiological outcome. Its application may also be extended into treating other benign bone lesions in hand. Level of Evidence: Level IV (Therapeutic).
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  • 文章类型: Systematic Review
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  • 文章类型: Review
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  • 文章类型: Case Reports
    未经证实:软骨粘液样化生很少会导致足底形成独特的肿瘤样增生。这被认为是一个反应性或恢复性过程,可能是慢性创伤造成的.对于粗心的皮肤病理学家来说,这可能是一个诊断挑战。在这里,我们回顾了临床,组织病理学,和一个17岁运动男孩的分子表现,右足底出现软组织肿块。显微镜检查显示具有丰富的软骨粘液样基质的梭形细胞相对有限的增殖,透明质化,和弥漫性ERG反应性。我们还回顾了该实体的特征,这些特征有助于将其与临床和组织病理学模拟物区分开,并假定与软组织软骨瘤和未成熟软骨样脉络膜瘤的可能联系。
    UNASSIGNED: Chondromyxoid metaplasia can rarely lead to the formation of a distinctive tumor-like proliferation in the plantar foot. This is thought to represent a reactive or reparative process, possibly due to chronic trauma. For the unwary dermatopathologist, this could represent a diagnostic challenge. Herein, we review the clinical, histopathological, and molecular presentation of an athletic 17-year-old boy with a soft tissue mass arising in the right plantar foot. Microscopic examination showed a relatively circumscribed proliferation of spindle cells with abundant chondromyxoid stroma, hyalinization, and diffuse ERG reactivity. We also review characteristics of this entity that help differentiate it from clinical and histopathologic mimics and postulate possible links with soft tissue chondromas and immature chondroid choristoma.
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  • 文章类型: Case Reports
    UNASSIGNED: Enchondroma is a solitary, benign, intramedullary cartilaginous tumor commonly noticed in the phalanges of hands and feet with characteristic radiological features. Its occurrence in aberrant sites with atypical features lead to diagnostic dilemma. Enchondromas which are usually managed non-operatively can mimic other benign and malignant lesions, especially chondrosarcoma.
    UNASSIGNED: We report the case of a 31-year-old farmer who presented with long standing inconspicuous pain in his left leg which turned out to be a diaphyseal enchondroma even though it demonstrated aggressive radiological features mimicking a chondrosarcoma. Incisional biopsy was done from the scalloped areas to obtain the correct histological diagnosis. He underwent thorough curettage of the lesion and remains asymptomatic 2 years after the procedure. We attempt to discuss the differentials which the orthopedic surgeon should keep in mind for diaphyseal lesions mimicking enchondroma.
    UNASSIGNED: Though classically found in metaphysis, Enchondromas are not uncommon in diaphysis of long bones. Enchondromas are generally benign, but can cause diagnostic dilemma when they present with aggressive features at rare locations and surgeons should be wary of the differentials. Despite a size of more than 6 cm and evidence of cortical erosion and intramedullary widening, the lesion could still be benign. Early biopsy will help to differentiate Enchondroma from a malignant transformation or malignant tumor.
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  • 文章类型: Case Reports
    A chondroma is a common benign cartilaginous tumor. However, a primary soft tissue chondroma of the posterior mediastinum is very rare. We herein report a case involving a 51-year-old man with a posterior mediastinal mass. The mass was dissected by thoracoscopy through the eighth intercostal space. Pathological examination led to a definitive diagnosis of a primary mediastinal chondroma with no criteria of malignancy. Preoperative diagnosis of a posterior mediastinal soft tissue chondroma is not easy because of its rarity and lack of typical features other than calcification. When a posterior mediastinal well-circumscribed soft tissue mass contains calcification and shows no obvious enhancement, the possibility of a soft tissue chondroma should be considered.
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  • 文章类型: Journal Article
    The spectrum of diagnoses and clinical features of hand tumors differ from those of tumors in other body parts. However, only a few reports have comprehensively referenced the diagnosis and clinical features of hand tumors. This study aimed to elucidate the diagnostic distribution and the clinical features of hand tumors undergone surgery in our institute.
    A total of 235 lesions in 186 patients diagnosed with hand tumors between 1978 and 2020 were reviewed. Age at surgery, gender, chief complaint, tumor location, and pathological diagnosis were analyzed.
    There were 121 benign bone tumors, 98 benign soft tissue tumors, and 16 malignant tumors. Chondroma and tenosynovial giant cell tumor were common benign bone and soft tissue tumors at the proximal phalanx of the ring finger and the palm, respectively. Meanwhile, chondrosarcoma and synovial sarcoma were common malignant tumors at the dorsal part of the hand. Local pain and painless mass were the chief complaints in patients with benign bone and soft tissue tumors, respectively. Most patients with malignant tumors were referred after unplanned resection. When patients were classified into two categories by tumor size according to maximal diameter, tumors larger than 19 mm had a significantly higher risk of malignant (p = 0.031) despite being smaller than other tumors in different body parts.
    When a tumor malignancy is suspected, the patient should be referred to a specialist to avoid unplanned resection or delayed diagnosis due to misdiagnosis. Knowing the distribution and clinical features should help in diagnosing hand tumors.
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  • 文章类型: Journal Article
    良性和恶性肿瘤可以像任何其他关节一样影响颞下颌关节(TMJ)。然而,TMJ肿瘤是罕见的,大多数是良性的。它们的临床表现是多种多样的,包括类似于TMJ功能障碍的症状学,耳科或神经病理学。在某些情况下,他们仍然完全无症状。因此,诊断是困难的,因为症状可能误导TMJ功能障碍或耳科疾病的错误诊断。因此,在症状发作和诊断之间经常存在长的延迟。种类繁多的TMJ病变解释了广泛的可能的治疗方式,主要是基于手术。我们在此对源自TMJ的病变进行综述。不讨论通过局部延伸影响TMJ的肿瘤或囊性下颌病变。骨瘤,骨样骨瘤,成骨细胞瘤,软骨瘤,骨软骨瘤,软骨母细胞瘤,腱鞘巨细胞瘤,巨细胞病变,非骨化性纤维瘤,血管瘤,在TMJ中发现的良性肿瘤中,脂肪瘤或朗格汉斯细胞组织细胞增生症都是可能的诊断。假瘤包括滑膜软骨瘤病和动脉瘤样骨囊肿。最后,TMJ的恶性肿瘤主要包括肉瘤(骨肉瘤,软骨肉瘤,滑膜肉瘤,尤因肉瘤,和纤维肉瘤),还有多发性骨髓瘤和继发性转移。我们将回顾临床,这些病变的放射学和组织学方面。还将讨论治疗和复发风险。
    Benign and malign tumors can affect the temporomandibular joint (TMJ) as any other articulation. Nevertheless, TMJ tumors are rare and mostly benign. Their clinical expression is varied including symptomatology similar to TMJ dysfunctional disorders, otologic or neurologic pathologies. In some cases, they remain totally asymptomatic. Hence, diagnosis is difficult since the symptomatology can be misleading with TMJ dysfunctional disorders or otologic disorders wrongly diagnosed. There is thus frequently a long delay between symptoms onset and diagnosis. The great variety of TMJ lesions explains the wide range of possible treatment modalities, mostly based on surgery. We provide here a review of the lesions originating from the TMJ. Tumoral or cystic mandibular lesion affecting the TMJ through local extension will not be discussed. Osteoma, osteoid osteoma, osteoblastoma, chondroma, osteochondroma, chondroblastoma, tenosynovial giant cell tumors, giant cell lesions, non-ossifying fibroma, hemangioma, lipoma or Langerhans cell histiocytosis are all possible diagnosis among the benign tumors found in the TMJ. Pseudotumors include synovial chondromatosis and aneurysmal bone cyst. Finally, malign tumors of the TMJ include mainly sarcomas (osteosarcoma, chondrosarcoma, synovial sarcoma, Ewing sarcoma, and fibrosarcoma), but also multiple myeloma and secondary metastases. We will review the clinical, radiological and histological aspects of each of these lesions. The treatment and the recurrence risk will also be discussed.
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