肌腱肿瘤及瘤样病变的声像图表现

Sonography of tumors and tumor-like lesions of tendons

起源于肌腱的肿瘤及瘤样病变较少见。本文拟介绍肌腱解剖、常见的肌腱肿瘤和瘤样病变,以及其声像图表现。肌腱的原发恶性肿瘤及转移瘤罕见,良性肿瘤及瘤样病变相对常见。肌腱的良性肿瘤表现为无痛或轻微触痛的软组织肿块,常见类型包括腱鞘巨细胞瘤、软骨瘤、骨软骨瘤、骨瘤、神经鞘瘤、海绵状淋巴管瘤、海绵状血管瘤、平滑肌瘤、纤维脂肪瘤等,约半数为腱鞘巨细胞瘤。肌腱原发性恶性肿瘤多发生于40~60岁,常见于下肢,主要为各种肉瘤,包括透明细胞肉瘤、滑膜肉瘤、上皮肉瘤。肌腱转移瘤以手部肌腱多见,大多来源于皮肤、关节或腱鞘肿瘤的直接蔓延,血行转移非常少见。肌腱瘤样病变多见于手部,腱鞘囊肿、表皮样囊肿及黄色瘤为最常见类型。

Tumors and tumor-like lesions arising from tendons are infrequent. Here we reviewed the anatomy of tendons and the common types of tumors and tumor-like lesions of tendons and their sonographic features. Primary malignant or metastatic tumors of tendons are very rare, while primary benign tumors and tumor-like lesions are relatively more common. Benign tumors of tendons occur as soft tissue masses which are usually painless or just slightly tender. The common types of benign tumors of tendons are giant-cell tumor, chondroma, osteochondroma, osteoma, neurinoma, cavernous lymphangioma, cavernous hemangioma, leiomyoma and fibrolipoma. About half of these tumors are giant-cell tumors. Primary malignant tumors of tendons usually occur during 40-60 years old and often arise in the lower extremity. They are mainly various sarcomas, including clear-cell sarcoma, synovial and epithelioid sarcoma. Metastatic tumors of tendons, which are common in the hand, usually occur by direct extension from tumorous skin, joint, or tendon sheath, and hematogenic metastases are extremely rare. Tumor-like lesions of tendons tend to occur in the hand. The most common types are tendon ganglia, epithelial cyst and xanthoma.