giant cell tumor

巨细胞瘤
  • 文章类型: Case Reports
    巨细胞瘤(GCT)是一种良性的局部侵袭性肿瘤,具有频繁复发和转移潜力。手足小骨的GCT很少见,具有高复发和转移的潜力。这项研究的目的是提供一个病例报告的GCT的第一meta骨的广泛切除,自体腓骨移植,与锁定板固定。
    一名18岁男性患者表现为足背内侧进行性肿胀1年。经临床检查,肿胀明显,局部征象提示左足第一跖骨底部良性骨肿瘤。放射学显示,由第一meta骨底部引起的膨胀性溶骨性病变,并伴有粗糙的隔膜和提示良性骨病变的特征。在局部麻醉下获得核心活检,组织病理学报告建议进行GCT。通过整块切除和腓骨自体移植重建手术干预,并用锁定钢板稳定。术后给予患者膝下石膏6周。6周后开始完全负重。在12个月的随访中,移植物吸收良好,在临床和放射学上均无复发迹象.
    与常规GCT相比,第一跖骨的GCT是一种罕见的实体,复发率更高。整块切除和自体腓骨钢板固定术是首选治疗方案。
    UNASSIGNED: Giant cell tumor (GCT) is a benign locally aggressive tumor with features of frequent recurrence and metastatic potential. GCT of small bones of hand and feet is rare with high recurrence and potential to metastasis. This study aims to provide a case report of GCT of the first metatarsal treated with wide excision, autologous fibular grafting, and fixation with locking plate.
    UNASSIGNED: An 18-year-old male patient presented with progressive swelling over the dorsomedial aspect of foot for 1 year. Upon clinical examination, the swelling was firm with local signs suggestive of a benign bony tumor arising from the base of first metatarsal of the left foot. Radiology reveals an expansile osteolytic lesion arising from the base of 1st metatarsal with coarse septations and features suggestive of a benign bone lesion. A core biopsy was obtained under local anesthesia and histopathology report suggested a GCT. Surgical intervention by en bloc excision and reconstruction by fibular autograft and stabilized with a locking plate was done. The patient was given a below-knee cast for 6 weeks postoperatively. Full weight bearing was started after 6 weeks. At 12 months of follow-up, the graft was well taken up and there were no signs of recurrence both clinically and radiologically.
    UNASSIGNED: GCT of 1st metatarsal is a rare entity with higher recurrence rate compared to conventional GCT. En bloc excision and autologous fibular graft with plate fixation are preferred treatment options.
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  • 文章类型: Case Reports
    骨巨细胞瘤(GCTB)是罕见的肿瘤,通常会影响长骨的骨phy,并在肋骨中不常见。在这里,我们报告一例无症状GCTB直接侵犯肺组织.
    方法:一名36岁男子因左侧胸痛被转诊至急诊科。计算机断层扫描显示左肺尖部有大量异质实性囊性肿块,左第四肋骨后部有无定形钙化和牵张。组织学检查还显示GCTB起源于肋骨。患者接受了整块切除术,在一年的随访中没有复发。
    GCTB的特征是破骨细胞样多核巨细胞,可以表现出侵袭性的局部行为。肋骨中的GCTB很少见,主要见于后弧。影像学特征包括骨重塑的溶解性病变,通常在长骨骨骨上偏心。侵袭性肿瘤可表现为皮质破坏和软组织扩张。GCTB管理通常推荐手术,旨在以足够的手术切缘完全切除。
    结论:缺乏明确的诊断标准阻碍了GCTB的准确诊断,通过放射学和组织学检查进行全面评估至关重要。在体检时,纵隔病变的鉴别诊断应考虑GCTB,不管他们的大小。此外,手术切除可以被考虑作为源自肋骨后弧的肿瘤的主要治疗策略。例如GCTB。
    UNASSIGNED: Giant cell tumors of bone (GCTB) are infrequent tumors that usually impact the epiphyses of long bones and uncommonly manifest in the ribs. Herein, we report a case of asymptomatic GCTB directly invading the lung tissue.
    METHODS: A 36-year-old man was referred to our emergency department with only left chest pain. Computed tomography revealed a large heterogeneous solid cystic mass in the left lung apex and amorphous calcification and distraction in the posterior part of the left fourth rib. Histological examination also exhibited that the GCTB originated from the rib. The patient underwent an en-bloc resection with no recurrence in his one-year follow-up.
    UNASSIGNED: GCTB is characterized by osteoclast-like multinucleated giant cells and can exhibit aggressive local behavior. GCTB in the rib is rare, mainly found in the posterior arc. Radiographic features include lytic lesions with bone remodeling, often seen eccentrically in long bone epiphyses. Aggressive tumors may show cortical destruction and soft tissue extension. Surgery is often recommended for GCTB management, aiming for complete resection with sufficient surgical margins.
    CONCLUSIONS: The absence of well-defined diagnostic criteria hinders the accurate diagnosis of GCTB, making a comprehensive assessment through radiological and histological examinations crucial. Upon physical examination, GCTB should be considered in the differential diagnosis for mediastinal lesions, regardless of their size. Furthermore, surgical removal can be taken into account as the primary treatment strategy for tumors that originate from the posterior arc of the ribs, such as GCTB.
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  • 文章类型: Journal Article
    桡骨远端巨细胞瘤(GCT)的治疗仍然具有挑战性,而最佳方法仍然是一个争论的问题。本系统评价和荟萃分析旨在比较长期刮宫术和广泛切除术的结果。治疗的支柱。
    Medline(通过PubMed),科克伦图书馆,WebofScience,谷歌学者,ClinicalTrials.gov,我们在Embase数据库中搜索了比较研究,这些研究评估了截至2023年4月桡骨远端GCT患者的长期刮宫联合辅助治疗和广泛切除联合重建治疗.收集数据并分析局部复发率,转移,整体并发症,和功能结果。纽卡斯尔-渥太华量表用于评估每项研究中的偏倚风险。
    纳入并分析了15项研究(n=373例患者)。进行刮宫的患者更有可能发生复发(风险比[RR]=3.02[95%置信区间;CI,1.87-4.89],P<.01),显示并发症较少(RR=0.32[95%CI,0.21-0.49],P<.01),并显示出视觉模拟量的较大改善和手臂的较低残疾,肩膀,和手评分(P<.00001)比接受广泛切除的患者。在转移方面没有发现显着差异(RR=1.03[95%CI,0.38-2.78],P=.95)。
    关于桡骨远端GCT的手术入路,与大范围切除重建相比,辅助治疗的刮宫复发的可能性更高。然而,刮宫法可显著降低手术并发症的发生率,疼痛评分降低,与切除组相比,功能结局更好。
    UNASSIGNED: The management of distal radius giant cell tumors (GCTs) remains challenging, and the optimal approach is still a matter of debate. This systematic review and meta-analysis aimed to compare the outcomes of extended curettage and wide resection, the mainstays of treatment.
    UNASSIGNED: Medline (via PubMed), Cochrane Library, Web of Science, Google Scholar, ClinicalTrials.gov, and Embase databases were searched for comparative studies that assessed extended curettage with adjuvant therapy and wide resection with reconstruction in patients with GCTs of the distal radius up to April 2023. Data were collected and analyzed on rates of local recurrence, metastasis, overall complications, and functional outcomes. The Newcastle-Ottawa scale was used to appraise the risk of bias within each study.
    UNASSIGNED: Fifteen studies (n = 373 patients) were included and analyzed. Patients who underwent curettage were more likely to develop recurrence (risk ratio [RR] = 3.02 [95% confidence interval; CI, 1.87-4.89], P < .01), showed fewer complications (RR = 0.32 [95% CI, 0.21-0.49], P < .01), and showed greater improvement in Visual Analog Scale and lower Disabilities of the Arm, Shoulder, and Hand scores (P < .00001) than those who underwent wide resection. No significant difference was found regarding metastasis (RR = 1.03 [95% CI, 0.38-2.78], P = .95).
    UNASSIGNED: Regarding the surgical approach to GCT of the distal radius, curettage with adjuvant therapy was associated with a higher likelihood of recurrence compared with wide resection with reconstruction. Nevertheless, the curettage approach resulted in significantly lower rates of operative complications, decreased pain scores, and better functional outcomes in comparison to the resection group.
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  • 文章类型: Journal Article
    巨细胞瘤(GCT)是具有侵袭性潜力的良性肿瘤,会破坏局部骨结构,这在关节周围位置尤其成问题。我们的目的是评估接受切除而不进行重建的尺骨远端GCT患者的预后。
    该研究包括21例尺骨远端GCT患者,这些患者接受了切除而不进行重建。有12名男性和9名女性,平均年龄30.4岁(范围14-45岁)。患者平均随访时间为4.4年,至少随访两年。
    疼痛的肿胀是所有病例的表现。19例患者为Campanacci3级,2例患者为Campanacci2级。尺骨远端的平均切除长度为6.8cm(范围4-10)cm。肌肉骨骼肿瘤协会评分(MSTS)为26.1。(范围22-28)。受影响的手的握力平均降低了10.5%。(范围0%-16%)。两名患者在就诊时患有多中心疾病,没有一例在就诊时患有病理性骨折。1例局部复发,经手术治疗。
    根据目前的研究,尺骨远端GCT,对于Campanacci2级和3级肿瘤,推荐不进行重建的整块切除作为一种有价值的治疗选择.切除尺骨远端而不进行重建可获得出色的功能结果,与前臂旋转运动和手的功能保存。根据文献综述,这是最大的GCTUlna系列,我们建议对该主题进行多中心和比较研究。
    UNASSIGNED: Giant Cell Tumours (GCT) are benign tumours with aggressive potential that disrupt the local bony architecture, which can be especially problematic in peri-articular locations. Our aim was to assess the outcomes of patients with GCT of the distal ulna who were treated by resection without reconstruction.
    UNASSIGNED: The study included 21 patients with distal ulna GCT that were treated with resection without reconstruction. There were 12 males and 9 females, with a mean age of 30.4years (range 14-45 years). The patients mean follow-up period was 4.4 years, with a two-year minimum follow-up.
    UNASSIGNED: Painful swelling was the presenting symtom in all cases. Nineteen patients had Campanacci grade 3 and two had Campanacci grade 2. The mean resected length of the distal ulna was 6.8 cm (range 4-10) cm. The Musculoskeletal Tumor Society score (MSTS) was 26.1. (range 22-28). Grip strength of the affected hand was reduced by 10.5% on average. (range 0%-16%). Two patients were having multi-centric disease on presentation and none of the cases had pathological fracture on presentation. One case had a local recurrence which was treated with surgery.
    UNASSIGNED: Based on current study, GCT of the distal ulna, en bloc resection without reconstruction can be recommended as a valuable treatment option for Campanacci grades 2 and 3 tumours. Resection of the distal end of the ulna without reconstruction results in excellent functional outcomes, with forearm rotational movement and hand function preserved. According to review of literature this is the largest series of GCT Ulna and we recommend a multicentre and comparitive studies on this topic.
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  • 文章类型: Journal Article
    巨细胞瘤(GCT)是罕见的,通常影响长骨的局部侵袭性肿瘤。然而,GCT也可以发生在颅面区域,包括上颌骨.此病例报告介绍了一名32岁男性患者上颌骨复发性巨细胞瘤的罕见病例。患者行上颌全切术,边缘清晰,这导致了成功的本地控制。这份报告突出了临床表现,诊断方法,治疗方式,与复发性上颌骨巨细胞瘤相关的良好预后。
    Giant cell tumors (GCTs) are rare, locally aggressive neoplasms that commonly affect the long bones. However, GCTs can also occur in the craniofacial region, including the maxilla. This case report presents a rare case of recurrent giant cell tumor of the maxilla in a 32-year-old male patient. The patient underwent a total maxillectomy with clear margins, which resulted in successful local control. This report highlights the clinical presentation, diagnostic approach, treatment modalities, and favorable prognosis associated with recurrent giant cell tumors of the maxilla.
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  • 文章类型: Case Reports
    腕骨骨巨细胞瘤(GCT)很少见。腕骨GCT通常为孤立性病变;多灶性受累是例外。这些病变在病灶内刮治后局部复发的风险高于其他身体区域。
    方法:我们介绍一例28岁男性,有6个月的左手腕背侧明显肿块病史。体格检查发现2厘米,温和温柔的弥撒。磁共振显示一个大的中间信号病变,涉及完全的骨骼和三角肌的远端部分。组织学检查证实了骨巨细胞瘤。该患者接受了延伸至锥体远端的hamate骨的整体切除术。使用聚甲基丙烯酸甲酯水泥(PMMA)重建缺陷,并实现了头端腕关节固定术。18个月的随访显示临床进展良好,腕部30°伸展的运动范围,30°屈曲,尺骨和桡骨偏离10°,没有肿瘤复发的证据。
    目前的文献表明腕骨GCT局部复发的发生率很高,所以建议广泛切除腕关节固定术,尤其是在CampanacciIII和多病灶参与中。
    结论:腕骨GCT是例外,主要影响哈马斯,Capetate,和舟骨。由于病灶内手术复发率高,大多数文献支持广泛切除腕骨GCT。
    UNASSIGNED: Giant cell tumors (GCTs) of bone in the carpus are rare. Carpal GCTs are usually solitary lesions; multifocal involvement is exceptional. These lesions have a higher risk of local recurrence after intralesional curettage than those in other body areas.
    METHODS: We present a case of a 28-year-old male with a six-month history of a palpable mass in the dorsal aspect of the left wrist. Physical examination revealed a 2 cm, mildly tender mass. Magnetic resonance revealed a large intermediate signal lesion involving completely hamate bone and the distal portion of the triquetrum. Histological examination confirmed a giant cell tumor of the carpus. The patient underwent en-bloc resection of the hamate bone extending to the distal part of the pyramidal. The defect was reconstructed using polymethylmethacrylate cement (PMMA), and intercarpal arthrodesis with the capitate was achieved. Follow-up at 18 months revealed a good clinical evolution, wrist range of motion of 30° of extension, 30° of flexion, and 10° of ulnar and radial deviation without evidence of tumoral recurrence.
    UNASSIGNED: The current literature suggests a high incidence of local recurrence in carpal GCT, so wide excision with carpal arthrodesis is recommended, especially in Campanacci III and multifocal involvement.
    CONCLUSIONS: Carpal GCT is exceptional, mainly affecting the hamate, capitate, and scaphoid. Most literature supports wide excision of carpal GCT owing to the high recurrence rate with intralesional procedures.
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  • 文章类型: Journal Article
    骨巨细胞瘤(GCT)是一种罕见的软组织肿瘤,占原发性骨肿瘤的3%-5%,<2%发生在头颈部。鼻腔是非常不寻常的表现部位。我们回顾了15例鼻腔和鼻旁窦GCT。我们在文献中增加1例。本文报告的病例,似乎是文献中描述的第二个鼻窝GCT,也是第一个记录的多灶性定位病例。描述了鼻腔多焦点GCT的情况。虽然在普通人群中很少见,在评估头颈部肿瘤时,应将GCT纳入鉴别诊断的可能性之中。这种特殊肿瘤的治疗仍然具有挑战性;手术切除仍然是黄金标准治疗,更喜欢微创经鼻入路以降低术中和术后发病率。喉镜,2023年。
    Giant cell tumors of bone (GCT) are rare soft tissue tumors, that account for 3%-5% of primary bone tumors with <2% occurring in the head and neck. The nasal cavity is a highly unusual site of presentation. We reviewed 15 cases of GCT of nasal cavity and paranasal sinuses. We add 1 case to the literature. The case herein reported, appears to be the second nasal fossa GCT described in the literature and the first documented case with multifocal localization. A case of multifocal GCT of the nasal cavity is described. Although rare in the general population, GCT should be included among the possibilities in the differential diagnosis when evaluating tumors of the head and neck. Management of this particular tumor remains challenging; surgical removal is still the gold standard treatment, preferring a minimally invasive trans-nasal approach to reduce intra and post-operative morbidity. Laryngoscope, 134:2774-2778, 2024.
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  • 文章类型: Case Reports
    棕色肿瘤是与甲状旁腺功能亢进相关的骨巨细胞局灶性病变,甚至主要或次要。为了正确治疗患者,必须将这些病变与其他颌骨巨细胞病变进行鉴别诊断。
    方法:我们在此通过描述其临床方面和影像学特征来介绍两例影响颌骨的棕色肿瘤。本病的诊断标准和治疗方法。
    棕色肿瘤是甲状旁腺功能亢进或肾功能衰竭患者的病变之一。包括上颌骨在内的骨骼可能是该病变的部位,此外,颌骨病变的影像学和组织病理学检查不足以确定诊断,这需要实验室测试和射线照相检查。
    结论:牙科医生应注意与全身性疾病相关的口腔表现,因此,仔细体检和彻底调查对于诊断和治疗成功的重要性。本文旨在说明在可疑的棕色肿瘤病例中帮助临床医生的管理策略。
    UNASSIGNED: Brown tumor is a giant cell focal lesion of bone associated with hyperparathyroidism, even primary or secondary. Differential diagnosis of these lesions from others giant cell lesions of the jaw bone is mandatory for the correct treatment of the patient.
    METHODS: We present here two cases of brown tumor affecting the jaws by describing their clinical aspects and radiographic features, diagnostic criteria and treatment of this disease.
    UNASSIGNED: Brown tumor is one of the lesions that develop in patients with hyperparathyroidism or renal failure. Skeletal bones including maxillo-facial ones can be the site of this lesion, also radiographic and histopathological exams of the jaw lesion are not sufficient to determine the diagnosis, which requires laboratory tests and radiographic examination.
    CONCLUSIONS: Dental surgeon should be aware of oral manifestations associated with systemic diseases, hence the importance of careful physical examination and thorough investigation for the diagnosis and treatment success. This article aims to illustrate the management strategy to aid clinicians in suspected cases of brown tumor.
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  • 文章类型: Review
    背景:可以使用前部切除骶骨肿块,后部,或组合方法。通过仅后部入路实现全骶骨切除术可缩短手术时间,组织损伤最小,并降低并发症的风险。
    目的:在本研究中,我们的目的是分享我们在26例患者中使用后路入路进行全骶骨切除术的经验,并在我们中心评估其临床结局.
    方法:这项回顾性研究检查了临床进展,手术反应,以及26例各种骶骨肿块病变患者的结局。我们从医院记录中获取了患者信息。
    结果:该研究包括14名男性(54%)和12名女性(46%),平均年龄49.8岁。大多数病例的BMI正常,六个人超重。12例患者进行了高水平的膀胱切除术,14例患者进行了中等水平的膀胱切除术。除了疼痛,在9例患者中观察到运动缺陷,5例发现括约肌功能障碍。术前栓塞11例。最常见的病变是脊索瘤(8例),恶性周围神经鞘瘤(4例),巨细胞瘤(3例),孤立性浆细胞瘤(3例)。只有一名患者在手术后出现了暂时性的部分运动缺陷。无脑脊液漏。5例患者出现局部复发,一个有远处转移。
    结论:通过后入路进行大型或巨大的骶骨肿瘤切除术既可行又安全,导致发病率降低,总生存率没有显著变化。
    Sacral masses can be removed using anterior, posterior, or combined approaches. Achieving total sacrectomy through a posterior-only approach results in a shorter procedure time, minimal tissue damage, and a reduced risk of complications. In this study, we aimed to share our experience with performing total sacrectomy using a posterior-only approach in 26 patients and to assess their clinical outcomes at our center.
    This retrospective study examines the clinical progression, surgical response, and outcomes of 26 patients with various sacral mass pathologies. We accessed patient information from our hospital records.
    The study included 14 men (54%) and 12 women (46%), with an average age of 49.8 years. Most cases had a normal body mass index, while 6 were overweight. Sacrectomy was performed at a high level in 12 patients and at a middle level in 14 patients. In addition to pain, motor deficits were observed in 9 patients, and sphincter dysfunction was found in 5. Preoperative embolization was conducted for 11 patients. The most prevalent lesions were chordoma (8 patients), malignant peripheral nerve sheath tumor (4 patients), giant cell tumor (3 patients), and solitary plasmacytoma (3 patients). Only 1 patient experienced a temporary partial motor deficit after surgery. There were no instances of cerebrospinal fluid leakage. Five patients experienced local recurrence, and 1 had distant metastasis.
    Performing sacrectomy for large or giant sacral tumors through a posterior approach is both feasible and safe, resulting in reduced morbidity and no significant change in overall survival.
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  • 文章类型: Journal Article
    桡骨远端很少受到原发性或转移性骨癌的影响。桡骨远端最常见的肿瘤是巨细胞瘤,有侵袭倾向的良性肿瘤.整块切除桡骨远端巨细胞瘤的复发率低,但损害了腕关节,需要进行重大重建,并具有功能性后果。桡骨远端骨肿瘤整块切除后的重建具有挑战性。此外,骨科肿瘤学家不同意最有效地治疗这种长骨异常。本文总结了桡骨远端肿瘤整块切除后进行的各种生物和非生物重建技术,讨论了每种重建策略的优缺点,并总结了几个案例研究和案例报告。
    The distal radius is rarely affected by either primary or metastatic bone cancers. The most frequent tumors of the distal radius are giant cell tumors, which are benign tumors with the propensity to invade. En bloc excision of giant cell tumors of the distal radius achieves a low recurrence rate but compromises the wrist joint, necessitates a significant reconstruction, and has functional consequences. Reconstruction after en bloc resection of a distal radius bone tumor is challenging. Furthermore, orthopedic oncologists disagree on treating such long bone anomalies most effectively. The present article summarizes the various biological and non-biological reconstruction techniques performed after en bloc resection of a distal radius tumor, discusses the advantages and disadvantages of each reconstruction strategy, and summarizes several case studies and case reports.
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