chondroma

软骨瘤
  • 文章类型: Case Reports
    软组织软骨瘤很少见,良性软骨肿瘤主要影响四肢,通常在没有明确性别偏爱的中年人中被诊断出来。尽管它们是良性的,由于生长缓慢,这些肿瘤可能会带来重大的诊断挑战,无症状性质,和模仿其他软组织肿瘤的潜力。
    我们报告一例27岁的男性,有8年的历史,在左脚第二脚趾的背侧有逐渐扩大的肿块,导致疼痛,行走困难,穿着鞋子。初步临床检查显示,患处无触痛肿胀,感觉减退。影像学检查结果表明软组织肿块伴有点状钙化,而磁共振成像显示,毗邻但并非由骨骼引起的信号强度病变较大。细针穿刺细胞学检查提示良性混合性肿瘤/软骨样汗管瘤。进行了切除活检,显示一个界限清楚的肿瘤,具有成熟透明软骨的小叶,与软组织软骨瘤的诊断一致。术后恢复顺利,除了局部皮瓣坏死通过植皮治疗。随访1年无复发。
    软组织软骨瘤,虽然罕见且良性,会显著影响患者的生活质量。正确诊断,包括全面评估和组织病理学确认,对于有效管理和预防不必要的干预措施至关重要。这个案例增加了对临床表现的宝贵见解,诊断挑战,软组织软骨瘤的管理策略。
    UNASSIGNED: Soft-tissue chondromas are rare, benign cartilaginous tumors predominantly affecting the extremities, often diagnosed in middle-aged individuals without a clear sex predilection. Despite their benign nature, these tumors can pose significant diagnostic challenges due to their slow growth, asymptomatic nature, and potential for mimicking other soft-tissue tumors.
    UNASSIGNED: We report a case of a 27-year-old male with an 8-year history of a progressively enlarging mass on the dorsal aspect of the second toe of the left foot, leading to pain, difficulty in walking, and wearing shoes. Initial clinical examination revealed a firm, non-tender swelling with hypoesthesia over the affected area. Radiographic findings suggested a soft-tissue mass with stippled calcification, while magnetic resonance imaging indicated a large altered signal intensity lesion abutting but not arising from the bone. Fine needle aspiration cytology hinted at a benign mixed tumor/chondroid syringoma. An excisional biopsy was performed, revealing a well-circumscribed tumor with lobules of mature hyaline cartilage, consistent with a diagnosis of soft-tissue chondroma. Post-operative period recovery was uneventful except for local flap necrosis which was managed with skin grafting. There was no recurrence at the 1-year follow-up.
    UNASSIGNED: Soft-tissue chondromas, while rare and benign, can significantly impact patients\' quality of life. Correct diagnosis, involving a comprehensive evaluation and histopathological confirmation, is crucial for effective management and prevention of unnecessary interventions. This case adds valuable insight into the clinical presentation, diagnostic challenges, and management strategies for soft-tissue chondromas.
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  • 文章类型: Evaluation Study
    在放射学上可能难以区分内生软骨瘤和低度恶性软骨瘤(1级)。这项研究旨在使用基于3D计算机断层扫描(CT)的影像组学分析来构建机器学习模型,以区分低级别软骨肉瘤和内生软骨瘤。这项回顾性研究共包括30例内生软骨瘤和26例软骨肉瘤患者。肿瘤体积分割由2名肌肉骨骼放射科医师手动进行。总的来说,每位患者获得107个影像学特征。使用组内相关系数来评估观察者间的可靠性,并估计2名放射科医生之间的绝对一致性。采用基于算法的信息增益作为特征约简方法,并检测到5个最重要的特征。对于分类,使用了7种机器学习模型。使用所有特征或5个特征进行分类。两位放射科医生对每位患者的107个特征有很好的一致性。因此,包含107个特征的数据集用于机器学习分类.当根据曲线下面积(AUC)值进行评估时,使用所有特征进行分类表明,朴素贝叶斯是最好的模型(AUC=0.950),而使用5个特征进行分类显示,随机森林是区分软骨肉瘤和内生软骨瘤的最佳模型(AUC=0.967)。总之,使用基于CT的影像组学分析的机器学习模型可用于区分低级别软骨肉瘤和内生软骨瘤。
    It may be difficult to distinguish between enchondroma and low-grade malignant cartilage tumors (grade 1) radiologically. This study aimed to construct machine learning models using 3D computed tomography (CT)-based radiomics analysis to differentiate low-grade chondrosarcoma from enchondroma. A total of 30 patients with enchondroma and 26 with chondrosarcoma were included in this retrospective study. Tumor volume segmentation was manually performed by 2 musculoskeletal radiologists. In total, 107 radiomic features were obtained for each patient. The intraclass correlation coefficient was used to assess interobserver reliability and estimate the absolute agreement between the 2 radiologists. Algorithm-based information gain was used as a feature reduction method, and the 5 most important features were detected. For classification, 7 machine learning models were utilized. Classification was carried out using either all features or 5 features. There was good to excellent agreement between the 2 radiologists for the 107 features of each patient. Therefore, a dataset containing 107 features was used for machine learning classification. When assessed based on area under curve (AUC) values, classification using all features revealed that naive Bayes was the best model (AUC = 0.950), while classification using 5 features revealed that random forest was the best model for differentiating chondrosarcoma from enchondroma (AUC = 0.967). In conclusion, machine learning models using CT-based radiomics analysis can be used to differentiate between low-grade chondrosarcoma and enchondroma.
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  • 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: Journal Article
    喉软骨瘤很少见,占所有喉部肿瘤的不到1%。软骨瘤是良性间质瘤,其特征是生长缓慢,主要起源于环状软骨,其次是甲状腺,Arytenoid,和会厌软骨.本范围审查旨在了解流行病学证据的范围,临床特征,发病率,喉软骨瘤(LC)复发。
    MEDLINE(Ovid),Embase(Elsevier),WebofScience(Clarivate),Cochrane中央对照试验和系统审查登记册,丁香花,Scopus,和谷歌学者数据库。
    范围审查于1816年至2023年进行,用于描述LC的观察性研究。标题和摘要进行了相关性筛选,然后对全文进行资格评估。数据是从合格的文章中收集的,并对结果进行了叙述性总结。
    一百一十九项研究符合纳入标准。94例病例报告,22个案例系列,和3个队列。描述了两百四名诊断为LC的参与者。男性:女性比例为2.8:1。最常见的定位是环状软骨(113;47.08%),其次是甲状腺(45;18.75%),andarytenoid软骨(27;11.25%)。呼吸困难(78.85%)和声音嘶哑(74.28%)是最多的报告症状。复发率为11.25%,切除后并发症并不常见。
    这项范围审查发现所有软骨喉肿瘤的低频率率。大多数患者接受了切除治疗,恶性肿瘤转化率低。该人群的归因死亡率较低,发病率,和复发根据目前的文献。
    UNASSIGNED: Cartilaginous tumors of the larynx are rare, representing less than 1% of all laryngeal tumors. Chondromas are benign mesenchymal tumors characterized by a slow-paced growth, primarily originated in the cricoid cartilage, followed by the thyroid, arytenoid, and epiglottic cartilages. This scoping review aims to understand the extent of evidence on the epidemiology, clinical characteristics, morbidity, and recurrence of the laryngeal chondroma (LC).
    UNASSIGNED: MEDLINE (Ovid), Embase (Elsevier), Web of Science (Clarivate), Cochrane Central Register of Controlled Trials and Systematic Reviews, Lilacs, Scopus, and Google Scholar databases.
    UNASSIGNED: The scoping review was conducted from 1816 to 2023, for observational studies describing LC. Titles and abstracts were screened for relevance, followed by an evaluation of the full text for eligibility. The data were collected from the qualifying articles, and a narrative summary of the outcomes was prepared.
    UNASSIGNED: One hundred and nineteen studies met the inclusion criteria. Ninety-four case reports, 22 case series, and 3 cohorts. Two hundred and four participants with a diagnosis of LC were described. Male:female ratio was 2.8:1. The most common localization was the cricoid (113; 47.08%), followed by the thyroid (45; 18.75%), and the arytenoid cartilage (27; 11.25%). Dyspnea (78.85%) and hoarseness (74.28%) were the most reported symptoms. The recurrence rate was 11.25%, and complications were uncommon following the resection.
    UNASSIGNED: This scoping review found a low-frequency rate over all the cartilaginous laryngeal tumors. Most patients were treated with resection, with a low rate of malignancy conversion. This population has low attributable mortality, morbidity, and recurrence according to the current literature.
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  • 文章类型: Journal Article
    进行这项研究是为了评估SPECT/CT影像组学参数在区分位于长骨中的内生软骨瘤和非典型软骨肿瘤(ACT)中的价值。回顾性分析了49例长骨内生软骨瘤或ACTs患者的定量HDPSPECT/CT数据。患者被随机分为训练(n=32)和测试(n=17)数据,并提取SPECT/CT影像组学参数。在训练数据中,LASSO用于特征减少。将选定的参数与经典的定量参数进行比较,以预测诊断。在测试数据中再次测试来自训练数据的重要参数。共有12例(37.5%)和6例(35.2%)患者在训练和测试数据中被诊断为ACTs,分别。LASSO回归选择了两个影像组学特征,区域的区域长度不均匀性(ZLNUGLZLM)和邻域灰度差的粗度(CoarsenessNGLDM)。多变量分析显示,较高的ZLNUGLZLM是预测ACTs的唯一显著独立因素,敏感性和特异性分别为85.0%和58.3%,分别,截止值为191.26。在测试数据中,较高的ZLNUGLZLM再次与ACTs的诊断相关,敏感性和特异性分别为83.3%和90.9%,分别。HDPSPECT/CT影像组学可以为区分内生软骨瘤和ACT提供附加价值。
    This study was performed to assess the value of SPECT/CT radiomics parameters in differentiating enchondroma and atypical cartilaginous tumors (ACTs) located in the long bones. Quantitative HDP SPECT/CT data of 49 patients with enchondromas or ACTs in the long bones were retrospectively reviewed. Patients were randomly split into training (n = 32) and test (n = 17) data, and SPECT/CT radiomics parameters were extracted. In training data, LASSO was employed for feature reduction. Selected parameters were compared with classic quantitative parameters for the prediction of diagnosis. Significant parameters from training data were again tested in the test data. A total of 12 (37.5%) and 6 (35.2%) patients were diagnosed as ACTs in training and test data, respectively. LASSO regression selected two radiomics features, zone-length non-uniformity for zone (ZLNUGLZLM) and coarseness for neighborhood grey-level difference (CoarsenessNGLDM). Multivariate analysis revealed higher ZLNUGLZLM as the only significant independent factor for the prediction of ACTs, with sensitivity and specificity of 85.0% and 58.3%, respectively, with a cut-off value of 191.26. In test data, higher ZLNUGLZLM was again associated with the diagnosis of ACTs, with sensitivity and specificity of 83.3% and 90.9%, respectively. HDP SPECT/CT radiomics may provide added value for differentiating between enchondromas and ACTs.
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  • 文章类型: Journal Article
    良性软组织软骨瘤是一种罕见的骨外软骨细胞肿瘤。它通常可以在四肢的骨骼系统中发现。头颈部是骨外软骨瘤最罕见的部位之一。最常见的站点是舌头,而其他子站点引起的病例很少。我们提出了一个56岁的绅士,他带着右咀嚼器空间膨胀来到我们的OPD。它对FNAC是非恶性的。他通过经腮腺入路进行了广泛的局部切除术。最终活检和IHC报告显示存在良性软骨细胞瘤-软组织软骨瘤(骨外)。没有使用进一步的治疗,此后一直在随访。据我们所知,这是第3例报道的咬肌间隙软骨瘤。
    在线版本包含补充材料,可在10.1007/s12070-023-03705-5获得。
    Benign soft tissue chondroma is a rare type of extraskeletal chondrocytic tumour. It usually can be found in skeletal system in extremities. Head and neck region is one of the most uncommon sites for extraskeletal chondroma .Most common site is tongue and there has been paucity of cases arising from the other subsites .We present a case of 56 years gentleman who came to our OPD with a right masticator space swelling. It was nonmalignant on FNAC. He underwent wide local excision through a transparotid approach. Final biopsy & IHC report showed presence of benign chondrocytic neoplasm- soft tissue chondroma (extraskeletal). No further therapy was used and he has been in follow up since then. To our knowledge ,this is the third reported case of masseteric space chondroma.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-03705-5.
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  • 文章类型: Journal Article
    目的:肩关节软骨瘤(EC)是良性骨内软骨肿瘤,非典型软骨肿瘤(ACT)代表其中间对应物。由于其他原因,通常在进行临床成像时偶然发现它们。到目前为止,仅在一项研究中分析了肩部EC的患病率,达到2.1%。
    方法:当前研究的目的是通过对45倍以上的数字进行回顾性分析来验证该数字。由21.550名患者组成的统一队列,这些患者在13.2年的时间跨度内接受了单个放射学中心的肩关节MRI检查.
    结果:21.550例患者中有93例表现为至少一个软骨肿瘤。4例患者同时出现2个病灶,共97个软骨肿瘤(89个ECs[91.8%],8种ACTs[8.2%])。根据93名患者,ECs和ACTs的总患病率分别为0.39%和0.04%.97例ECs/ACTs的平均大小为2.3±1.5cm;大多数肿瘤位于肱骨近端(96.9%),在干phy端(60.8%)和外周(56.7%)。在所有病变中,94例肿瘤(96.9%)位于肱骨,3例(3.1%)位于肩胛骨。
    结论:肩关节EC/ACT的频率似乎被高估了,目前的研究显示患病率为0.43%。
    OBJECTIVE: Enchondromas (EC) of the shoulder joint are benign intraosseous cartilage neoplasms, with atypical cartilaginous tumours (ACT) representing their intermediate counterpart. They are usually found incidentally on clinical imaging performed for other reasons. Thus far the prevalence of ECs of the shoulder has been analysed in only one study reaching a figure of 2.1%.
    METHODS: The aim of the current study was to validate this number via retrospective analysis of a 45 times larger, uniform cohort consisting of 21.550 patients who had received an MRI of the shoulder at a single radiologic centre over a time span of 13.2 years.
    RESULTS: Ninety-three of 21.550 patients presented with at least one cartilaginous tumour. Four patients showed two lesions at the same time resulting in a total number of 97 cartilage tumours (89 ECs [91.8%], 8 ACTs [8.2%]). Based on the 93 patients, the overall prevalence was 0.39% for ECs and 0.04% for ACTs. Mean size of the 97 ECs/ACTs was 2.3 ± 1.5 cm; most neoplasms were located in the proximal humerus (96.9%), in the metaphysis (60.8%) and peripherally (56.7%). Of all lesions, 94 tumours (96.9%) were located in the humerus and 3 (3.1%) in the scapula.
    CONCLUSIONS: Frequency of EC/ACT of the shoulder joint appears to have been overestimated, with the current study revealing a prevalence of 0.43%.
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  • 文章类型: Journal Article
    软骨肉瘤是最常见的软骨恶性肿瘤,与异柠檬酸脱氢酶1(IDH1)和IDH2基因的体细胞突变有关。体细胞IDH突变也在其良性前体病变中发现,中性腺,提示IDH突变是恶性转化的早期事件。在我们的研究中研究的发展为内生软骨瘤的人突变IDH软骨肉瘤和突变Idh小鼠仅在来自IDH突变软骨肉瘤和Idh1突变鼠生长板的突变细胞中显示糖原沉积。糖原利用的药物阻断诱导肿瘤细胞行为的变化,下游能量通路,和体内外肿瘤负荷。突变体IDH1与缺氧诱导因子1α(HIF1α)相互作用,调节糖原代谢关键酶的表达。这里,我们显示糖原在软骨瘤和软骨肉瘤中的关键作用,这可能是通过与突变体IDH1和HIF1α的相互作用介导的。
    Chondrosarcomas are the most common malignancy of cartilage and are associated with somatic mutations in isocitrate dehydrogenase 1 (IDH1) and IDH2 genes. Somatic IDH mutations are also found in its benign precursor lesion, enchondromas, suggesting that IDH mutations are early events in malignant transformation. Human mutant IDH chondrosarcomas and mutant Idh mice that develop enchondromas investigated in our studies display glycogen deposition exclusively in mutant cells from IDH mutant chondrosarcomas and Idh1 mutant murine growth plates. Pharmacologic blockade of glycogen utilization induces changes in tumor cell behavior, downstream energetic pathways, and tumor burden in vitro and in vivo. Mutant IDH1 interacts with hypoxia-inducible factor 1α (HIF1α) to regulate expression of key enzymes in glycogen metabolism. Here, we show a critical role for glycogen in enchondromas and chondrosarcomas, which is likely mediated through an interaction with mutant IDH1 and HIF1α.
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  • 文章类型: Case Reports
    关节周围软骨瘤常见于肱骨和股骨,但很少发生在颞下颌关节。我们报告了一例耳前部的软骨瘤。在他访问前一年,一名53岁的男子意识到右脸颊区域的肿胀逐渐增加。在右耳的前部,有一个25毫米的肿瘤,弹性和坚硬,流动性差,没有压痛。对比增强计算机断层扫描CT显示腮腺上极有弥漫性钙化或骨化的肿块病变,内部对比度较差。磁共振成像显示腮腺有低信号肿块病变,T1和T2均有高信号。细针穿刺细胞学无法诊断。使用神经监测系统,用腮腺上极的正常组织切除肿瘤,方法与腮腺良性肿瘤相同。区分多形性腺瘤,包括腮腺的弥漫性微钙化和颞下颌关节的软骨肿瘤,有时可能很难。在这种情况下,手术切除可能是一个有益的治疗选择。
    Periarticular chondromas are common in the humerus and femur but rarely occur in the temporomandibular joint. We report a case of a chondroma in the anterior part of the ear. One year prior to his visit, a 53-year-old man became aware of swelling in the right cheek region which gradually increased in size. In the anterior part of the right ear, there was a palpable 25 mm tumor, elastic and hard, with poor mobility and without tenderness. A contrast-enhanced computed tomography CT showed a mass lesion with diffuse calcification or ossification in the upper pole of the parotid gland and areas of poor contrast within. A magnetic resonance imaging showed a low-signal mass lesion at the parotid gland with some high signals in both T1 and T2. Fine-needle aspiration cytology did not lead to diagnosis. Using a nerve monitoring system, the tumor was resected with normal tissue of the upper pole of the parotid gland in the same way as for a benign parotid tumor. Distinguishing between pleomorphic adenoma, including diffuse microcalcification of the parotid gland and cartilaginous tumors of the temporomandibular joint, may be sometimes difficult. In such cases, surgical resection may be a beneficial treatment option.
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  • 文章类型: Journal Article
    背景:膝关节的软骨瘤(EC)和非典型软骨瘤(ACT)代表骨的良性/中间软骨瘤,通常是偶然发现的。基于小到中等规模的队列,MRI显示的膝关节软骨肿瘤的患病率估计为0.2-2.9%.这项研究旨在通过对更大的数字进行回顾性检查来验证/挑战这些数字,统一的患者队列。
    方法:在01.01.2007和01.03.2020之间,有44,762名患者在放射学中心接受了膝关节MRI检查。其中,697例MRI报告软骨病变阳性。在三步工作流程中,46名患者被一名训练有素的合著者排除在外,放射科医生和骨科肿瘤科医生,被错误诊断为软骨瘤。
    结果:在44,762名患者中,651出现至少一种EC/ACT,表明膝关节良性/中间软骨肿瘤的患病率为1.45%(EC:1.4%;ACT:0.05%)。21例患者显示2个软骨瘤病变,总共672个肿瘤(650个ECs[96.7%]和22个ACTs[3.3%])可以根据肿瘤特征进行分析:平均大小为1.6±1.1厘米,大多数病变位于股骨远端(72.9%),在各自骨的干phy端(58.9%)和髓管的中央(57.4%)。
    结论:这项研究显示膝关节周围软骨损伤的总患病率为1.45%。虽然在13.2年内发现ECs的患病率持续增加,ACTs的患病率保持不变。
    BACKGROUND: Enchondromas (EC) and atypical cartilaginous tumours (ACT) of the knee joint represent benign/intermediate chondromatous neoplasms of the bone that are most commonly discovered incidentally. Based on small to intermediate-sized cohorts, the prevalence of cartilaginous tumours of the knee as visible in MRI is estimated at 0.2-2.9%. This study aimed at verifying/challenging these numbers via retrospective examination of a larger, uniform patient cohort.
    METHODS: Between 01.01.2007 and 01.03.2020, 44,762 patients had received an MRI of the knee for any indication at a radiologic centre. Of these, 697 patients presented with MRI reports positive for cartilaginous lesions. In a three-step workflow, 46 patients were excluded by a trained co-author, a radiologist and an orthopaedic oncologist, as wrongly being diagnosed for a cartilage tumour.
    RESULTS: Of 44,762 patients, 651 presented with at least one EC/ACT indicating a prevalence of 1.45% for benign/intermediate cartilaginous tumours of the knee joint (EC: 1.4%; ACTs: 0.05%). As 21 patients showed 2 chondromatous lesions, altogether 672 tumours (650 ECs [96.7%] and 22 ACTs [3.3%]) could be analysed in terms of tumour characteristics: With a mean size of 1.6 ± 1.1 cm, most lesions were located in the distal femur (72.9%), in the metaphysis of the respective bone (58.9%) and centrally in the medullary canal (57.4%).
    CONCLUSIONS: This study revealed an overall prevalence of 1.45% for cartilage lesions around the knee joint. Whilst a constant increase in prevalence was found for ECs over 13.2 years, prevalence remained constant for ACTs.
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