复发恶性骨肿瘤的临床病理X线分析

Analysis of Clinical,X ray and Pathology on Recurrent Malignant Bone Tumor

复习１４例复发恶性骨肿瘤的临床、病理、Ｘ线资料。男１０例，女４例，年龄平均２７．８岁，骨肉瘤５例，骨巨细胞瘤３例，恶性纤维组织细胞瘤２例，软骨肉瘤３例，恶性骨母细胞瘤１例，通过分析发现复发的原因为：手术不彻底，术中没有按无瘤操作，手术前后没有及时、正确应用各种辅助治疗，复发常表现为：原手术部位疼痛或出现肿块，Ｘ线片示病变范围增大，瘤骨或瘤软骨形成或出现软组织肿块，ＥＳＲ和ＡＬＰ升高，复发后肿瘤的组织学类型无变化，但细胞的增殖能力较前增强，复发后若位于可完整切除的骨骼或周围软组织未受侵袭，可行保肢术；反之需行截肢或关节离断术。

Fourteen patients with recurrent bone tumor treated in our hospital were reviewed.There were 10 males,4 females and the average age was 27 8 years.The recurrent tumors were osteosarcoma in 5 cases,giant cell tumor of bone in 3 cases,malignant fibrous histiocytoma in 2,chondrosarcoma in 3 and malignant osteoblastoma in one case.The recurrent reasons were found as follows:tumor resected incompletely,operation performed in tumor edge and the supplementary treatment used improperly pre and postoperatively.The main manifestation of recurrnent were pain and lump on operative location,the size of primary location enlarged neoplastic bone or chondral and soft tissue lump appeared on X ray plane film,ESR and ALP raised.Comparative investigating slices,we found the aggressive ability of tumor cell enhanced.The therapy rules of recurrent malignant bone tumor were discussed.