4例去分化软骨肉瘤诊治体会

Diagnosis and treatment of 4 cases of dedifferentiated chondrosarcoma

目的探讨去分化软骨肉瘤的诊断、治疗及其预后。方法回顾性分析4例去分化软骨肉瘤的诊断、治疗及其预后。术前行X线、CT、MRI检查及穿刺病理活检明确诊断。肱骨近端1例接受保肢治疗,股骨2例行髋关节解脱术,骨盆1例行半骨盆切除术。患者术前未进行新辅助化疗,术后均接受辅助化疗。结果术后病理检查均为去分化软骨肉瘤。4例患者分别于术后13、24、28、35个月死亡。结论去分化软骨肉瘤是高度恶性肿瘤,早期明确诊断、迅速进行根治性或广泛性切除肿瘤是提高生存率的关键。

Objective To discuss the diagnosis, treatment and prognosis of dedifferentiated chondrosarcoma. Meth- ods The diagnosis, treatment and prognosis of the 4 patients with dedifferentiated chondrosarcoma was retrospective- ly studied. All cases were diagnosed with line X-ray, CT, MRI and puncture biopsy pathology before operation. One case of proximal humerus was treated with limb salvage surgery, 2 cases of femur with disarticulation of the hip, and 1 case of pelvis with hemipelvectomy. All the patients did not get preoperative neoadjuvant chemotherapy, but they all got adjuvant chemotherapy after the surgery. Results The pathological diagnosis were all dedifferentiated chondro- sarcoma. The 4 patients died at the 13th,24th ,28th, 35th month postoperatively. Conclusions Dedifferentiated chondrosarcoma is a highly malignant tumor. Early diagnosis, prompt radical or extensive resection of the tumor are the key points to improve the survival rate.