软组织内腱鞘巨细胞瘤的诊治:附33例病例分析
Diagnosis and Treatment of Extra-articular Tenosynovial Giant Cell Tumor in Soft Tissue:A Report of 33 Cases
刘起昆 1于小钧 1鲍远 1康皓1
作者信息
- 1. 华中科技大学同济医学院附属同济医院骨科,武汉 430030
- 折叠
摘要
目的 探讨罕见部位关节外型腱鞘滑膜巨细胞瘤(tenosynovial giant cell tumor,TSGCT)的临床特征、影像学表现及预后,以提高对该病的认识.方法 检索文献中报道的病例,结合本院收治的2例患者资料进行回顾性分析.结果 33例患者纳入本次研究,其中男性17例,女性16例,平均年龄39.8岁,肿瘤最大直径平均值为7.2 cm.发病部位多为大腿、臀部及头颈部.主要的临床表现为单纯包块(39.4％)和疼痛伴肿胀(12.1％).CT检查表现为等密度或稍低密度的软组织肿块,病灶内无钙化或骨化.MRI主要表现为T1WI低信号或等-低信号,T2WI大部分(95.2％)为混杂信号,增强多为不均匀强化.17例获得随访的患者术后发生复发或转移的风险为17.6％.结论 完全关节外型TSGCT非常罕见.对于来源于下肢及头颈部、MRI表现为混杂信号、CT显示关节外来源的软组织肿块需要考虑到该病,手术能有效控制其进展.
Abstract
Objective To investigate the clinical features,imaging manifestations and prognosis of tenosynovial giant cell tumor(TSGCT)in a rare site in order to improve the understanding of the disease.Methods Thirty-one cases reported in the literature were retrieved,and the data of two patients admitted to our hospital were retrospectively analyzed.Results Among the 33 patients,17 were male and 16 were female,with a mean age of 39.8 years and a mean maximum tumor diameter of 7.2 cm.The tumors were mostly loca-ted in the thigh,buttock,head and neck.The main clinical manifestations were masses(39.4％)and pain with swelling(12.1％).Soft tissue masses of equal or slightly low density were detected through CT examination,and there was no calcification or ossification in the lesion.Mainly low signal or mixed iso-hypo signal in T1WI and mostly mixed signal in T2WI(95.2％)were detected through MRI,and the enhancement was heterogeneous.The risk of recurrence or metastasis was 17.6％in 17 patients who were followed-up.Conclusion Extra-articular TSGCT within soft tissue is very rare.Diagnosis of TSGCT should be considered,if there were soft tissue masses from lower extremities,head and neck.Mixed signals were observed on MRI,and extra-articular sources were observed on CT.Surgical treat-ment can effectively control the progress of TSGCT.
关键词
腱鞘滑膜巨细胞瘤/关节外病变/临床病理特征/诊断Key words
tenosynovial giant cell tumor/extra-articular disease/clinicopathologic characteristic/diagnosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据