复发骨巨细胞瘤12例的治疗体会

Therapeutic experience of recurrent giant cell tumor of bone in 12 cases

目的:探讨骨巨细胞瘤(GCT)术后复发的手术方法及疗效。方法:回顾分析我院收治的12例复发性GCT的临床资料。外科治疗依据病理和影像学分期,进行扩大的肿瘤刮除、辅助囊壁处理或肿瘤切除功能重建。结果:平均随访36个月,疗效满意。结论:肿瘤局限在包壳内,无明显软组织肿块形成,再次刮除空腔充填;肿瘤体积较大特别是当肿瘤突破骨性包壳并有明显的软组织肿块形成,则选择瘤段(广泛)切除后功能重建,选择性治疗可获得满意的疗效。

Objective：To explore the surgical treatment for the postoperative recurrence of giant cell tumor（GCT） of bone and to study its therapeutic effect.Methods：A total of 12 cases of recurrent GCT in extremities from June 2000 to May 2010 were retrospectively analyzed.The surgical treatment was adopted according to the pathological and imageological stages,including extended tumor curettage,adjuvant treatment of capsule wall or tumor resection with functional reconstruction.Results：The mean follow-up was 36 months.The treatment effects were satisfactory.Conclusion：Extended curettage with adjuvant treatment of the capsule wall could be selected for treating GCT localized in involucrum without obvious soft tissue lump formation.GCT with large volume,especially with tumor penetrating bony involucrum and obvious soft tissue lump could be treated by functional reconstruction after tumor extended resection.Selective treatment can obtain the satisfactory effects.