背景:软骨母细胞瘤(CB),一种产生软骨细胞的罕见良性骨肿瘤,通常在儿童和年轻人的骨phy或骨上发展。这些罕见肿瘤的治疗是复杂的。标准治疗方案包括用局部佐剂刮除和骨移植或水泥应用。作者检查了38个CBs以确定局部复发的危险因素,并发症,骨粘连刮治后的功能结局。
方法:回顾性分析了2000年1月至2021年6月在我院就诊的22名10至17岁的女孩和16名男孩的软骨母细胞瘤。临床数据,射线照相图像,组织学结果,治疗,功能结果,并检查局部复发率-手术治疗涉及全肿瘤刮除,其次是骨移植和辅助技术。局部复发也有报道。
结果:最常见的部位是股骨近端。受累部位包括10例(26.3%)股骨近端,胫骨近端8例(20.8%),肱骨5例(13.2%),胫骨远端4例(10.5%),股骨远端3例(7.9%),股上区域3例(7.9%),距骨1例(2.6%),跟骨1例(2.6%),肩胛骨1例(2.6%),腰椎1例(2.6%),1例(2.6%)患者的髂骨。平均随访时间为144.2个月(24至276个月)。局部复发率为7.9%。肌肉骨骼肿瘤协会(MSTS)的平均评分为28.3分(17至30)。出现时症状的平均持续时间为5.8(范围,1至28)个月。
结论:侵袭性刮除和植骨导致大多数儿科患者的局部控制和良好的预后。在相对较小比例的案件中,由于生长板损伤和晚期诊断,可发生长期并发症和复发。在儿科诊所收治的疼痛患者中,常伴有局部水肿和关节积液,通过先进的放射扫描进行早期检测(X射线,CT,或MRI)可以防止诊断延迟。
BACKGROUND: Chondroblastoma (CB), a rare benign bone tumor that produces chondrocytes, often develops in the epiphysis or apophysis of children and young adults. The treatment of these rare tumors is complex. The standard treatment protocol involves curettage with local adjuvants and bone graft or cement application. The authors examined 38 CBs to determine risk factors for local recurrence, complications, and functional outcomes following epiphyseal curettage.
METHODS: Twenty-two girls and sixteen boys aged 10 to 17 years with histologically confirmed
chondroblastoma who arrived at our hospital between January 2000 and June 2021 were reviewed retrospectively. Clinical data, radiographic images, histological results, treatment, functional outcomes, and the local recurrence rate were examined-surgical treatment involved total tumor curettage, followed by bone grafting and adjuvant techniques. Local recurrences have also been reported.
RESULTS: The most frequently affected site was the proximal femur. Sites of involvement included the proximal femur in 10 (26.3%) cases, the proximal tibia in 8 (20.8%), the humerus in 5 cases (13.2%), the distal tibia in 4 cases (10.5%), the distal femur in 3 cases (7.9%), the supracetabular region in 3 cases (7.9%), the talus in 1 case (2.6%), the calcaneus in 1 case (2.6%), the scapula in 1 case (2.6%), the lumbar spine in 1 case (2.6%), and the iliac bone in 1 (2.6%) patient. The mean follow-up was 144.2 months (24 to 276). The local recurrence rate was 7.9%. The mean Musculoskeletal Tumor Society (MSTS) score was 28.3 points (17 to 30). The mean duration of symptoms at presentation was 5.8 (range, 1 to 28) months.
CONCLUSIONS: Aggressive curettage and bone grafting resulted in local control and good outcomes in most pediatric patients. In a relatively small proportion of cases, long-term complications and recurrence can occur due to growth plate damage and late diagnosis. In patients admitted to the pediatric clinic with pain, which is often accompanied by localized edema and joint effusion, early detection via advanced radiological scans (X-ray, CT, or MRI) may prevent delays in diagnosis.