手部腱鞘巨细胞瘤复发原因分析

Analysis of recurrence cause of giant cell tumor of tendon sheath in hand

目的探讨手部腱鞘巨细胞瘤的好发部位,以及临床上出现骨皮质侵蚀,受累关节退行性改变与肿瘤复发的关系。方法回顾分析1993～2003年间32例手部腱鞘巨细胞瘤入院患者的病史、体格检查、影像学检查,所有病例均行手术治疗,并就其性别、年龄、肿瘤生长部位及出现骨皮质侵蚀,受累关节退行性改变进行分析。结果该肿瘤好发于青壮年女性,左手好发,好发部位为拇指和中指。复发病例中常见骨皮质侵蚀和关节融合的退行性改变。结论局部瘤体切除是治疗腱鞘巨细胞瘤的最佳治疗方案,对多次复发有恶变倾向者应行根治性手术。

Objective To discuss the location of giant cell tumor of tendon sheath(GCTTS) in hand,and the relation between bony erosion,degenerative change and recurrence of the tumor.Methods Thirty-two cases(1993-2003) with giant cell tumor of tendon sheath in hand were retrospectively analysed for gender,age,lesion location,bony erosion and degenerative change. Results The gender,age,and distribution of GCTTS tendencies female,young age,left hand,thumb and middle fingers. Bony erosion and degenerative change in recurrent cases were commonly present. Conclusion Local excision of GCTTS was the most adaptive treatment.Amputation of the finger is indicated for obvious malignant and recurrence tendency of GCTTS.