骨巨细胞瘤的诊断与治疗

Diagnosis and treatment of giant cell tumor of bone

骨巨细胞瘤是一高侵袭性良性肿瘤,主要发生于年轻人中,骨端发病。典型的影像学表现是骨端完全溶骨的膨胀性改变,多不伴有骨膜反应及软组织包块。CT及MRI可以很好地显示肿瘤的侵及范围,X线平片最具诊断意义。圆形及卵圆形基质细胞及多核巨细胞是骨巨细胞瘤的基本组织构成成分。刮除术是治疗骨巨细胞瘤的基本外科手段,但其复发率较高,应加用物理及化学的方法扩大至边缘或广泛的外科治疗边界。放疗可用于治疗难以手术的病例,但可致肉瘤变。化疗对于骨巨细胞瘤基本无效。骨巨细胞瘤的转移及恶变可能与以往治疗有关。

Giant cell tumor(GCT)of bone is a hyperinvasion primary benign bone tumor.GCTs mostly occur in the young adults and located at the end of long tubular bone.The typical imagine characteristics are totally osteolytic and expensive lesion with little soft tissue mass and reactive new bone formation.Plain film has the most diagnostic value.GCT histologically composes of stroma cells and multi-nuclear giant cells.Curettage is the most contemporary procedure to treat GCTs surgically and the most problem is local recurrence and adjuvant could reduce the relapse rate.Radiation is only used for non-operatable patients and chemotherapy is useless for GCT.Metastasis and malignancy change of GCT may be related with prior surgical or other procedures.