目的:本研究的目的是探讨临床,骨外骨肉瘤(EOS)的影像学和病理学特征,提高对该病和其他类似病变的认识。
方法:11例经病理证实的骨外骨肉瘤患者的资料,包括肿瘤部位和大小以及影像学和临床表现,进行了回顾性分析。
结果:6例患者为男性(60%),5例为女性(40%);患者年龄23~76岁(平均年龄47.1岁).在11名患者中,7例钙化或骨化明显,形态不同,2例患者表现出巨大的成熟骨肿瘤。MRI显示混合信号团,肿瘤实质中的T1和T2信号稍长。增强的CT和MRI扫描显示实质增强。10例患者出现不同程度的坏死和囊性变性,其中2人并发出血,MRI显示“液体-液体水平”迹象。在11名患者中,五名患者在手术后幸存下来,影像学检查未见明显复发或转移。一名患者手术后死于肺转移,2例患者因疾病进展而死亡。1例患者术后2个月因呼吸衰竭死亡。2例患者手术切缘阳性,1例术后6个月出现肺转移,术后19个月死亡。另一例患者术后2个月复发。
结论:EOS的诊断需要结合临床,影像学和组织学检查。囊性变性和坏死;矿化很常见,特别是厚而块状的矿化。扩大切除仍是局部病变的首选。对于手术切缘阳性或转移灶的患者,需要辅助放化疗。
OBJECTIVE: The aim of this study was to investigate the clinical, imaging and pathological features of extraskeletal osteosarcoma (EOS) and to improve the understanding of this disease and other similar lesions.
METHODS: The data for 11 patients with pathologically confirmed extraosseous osteosarcoma, including tumour site and size and imaging and clinical manifestations, were analysed retrospectively.
RESULTS: Six patients were male (60%), and 5 were female (40%); patient age ranged from 23 to 76 years (average age 47.1 years). Among the 11 patients, 7 had clear calcifications or ossification with different morphologies, and 2 patients showed a massive mature bone tumour. MRI showed a mixed-signal mass with slightly longer T1 and T2 signals in the tumour parenchyma. Enhanced CT and MRI scans showed enhancement in the parenchyma. Ten patients had different degrees of necrosis and cystic degeneration in the mass, 2 of whom were complicated with haemorrhage, and MRI showed \"fluid‒fluid level\" signs. Of the 11 patients, five patients survived after surgery, and no obvious recurrence or metastasis was found on imaging examination. One patient died of lung metastasis after surgery, and 2 patients with open biopsy died of disease progression. One patient died of respiratory failure 2 months after operation. 2 patients had positive surgical margins, and 1 had lung metastasis 6 months after operation and died 19 months after operation. Another patient had recurrence 2 months after surgery.
CONCLUSIONS: The diagnosis of EOS requires a combination of clinical, imaging and histological examinations. Cystic degeneration and necrosis; mineralization is common, especially thick and lumpy mineralization. Extended resection is still the first choice for localized lesions. For patients with positive surgical margins or metastases, adjuvant chemoradiotherapy is needed.